756 Prophylactic salpingo-oophorectomy in BRCA 1–2 patients. Profile epidemiological

Abstract

Introduction/Background∗ Familial predisposition has been described in 5-10% of women who develop ovarian cancer. Women with germ-line BRCA1/2 mutations have an increased risk of breast and ovarian cancer as compared with the rest of the population. Women with BRCA1 mutation have a 44% lifetime risk of developing ovarian cancer, whereas, BRCA2 mutation has lifetime risks of 17%. These women often undergo bilateral prophylactic oophorectomy to reduce this risk. The objective of this study was to analyze the epidemiological characteristics of patients with BRCA 1/2 mutation undergoing prophylactic salpingoophorectomy for adnexal highgrade serous epithelial carcinoma. Methodology We performed a prospective cohort study between January 2013 to January 2021. Patients with BRCA 1/2 mutations who underwent prophylactic bilateral salpingoophorectomy were included. A descriptive study of epidemiological characteristics of these patients was performed. All statistical analysis was performed with Stata/IC 13.0 for Windows. Result(s)∗ We analyze the epidemiological characteristics of 115 patients that were included. Of them, 50.4% (58) had BRCA 1 mutation and 49.6% (57) BRCA 2 mutation. Most occult ovarian carcinomas are found in women over 45 years of age. The median age at surgery was 49.2 (standar deviation, SD 5.8) years and 59.1% (68) of patients were posmenopausal. Fifty (43.5%) of them were the family index case (first case of cancer) and sixty (52.2%) had a previous diagnosis of breast cancer. The most frequent family history was: two cases of breast cancer in their family of 1 or 2 degree whose sum of ages at diagnosis was less than 120 years. The median Ca 125 value prior to surgery was 29.4 u/L. Adnexal findings were described in presurgery ultrasound as normal (104, 90.4%) or bening cyst (11, 17.4%). Conclusion∗ Most occult carcinomas are found in women over 45 years of age. Unfortunately, there is no screening test effective in detecting ovarian cancer at early stages. Therefore, the current recommendation is to undergo riskreducing bilateral salpingo-oophorectomy after completing the gestational desire in carriers of BRCA1/2 mutations. Although, the main negative consequence of this surgery in premenopausal women is premature menopause. However, the risk is balanced by the morbidity and mortality associated with ovarian cancer, and these symptoms can be treated with some drugs.