High-grade serous carcinoma at risk-reducing salpingo-oophorectomy in asymptomatic carriers of BRCA1/2 pathogenic variants

Carriers of BRCA1 and BRCA2 pathogenic variants (PVs) have an increased lifetime risk of developing ovarian cancer. The most diagnosed subtype is high-grade serous carcinoma (HGSC). A multicenter study in The Netherlands investigated the prevalence of HGSC at risk-reducing salpingo-oophorectomy among asymptomatic BRCA1/2-PV carriers. HGSC was detected in 1.5% of BRCA1 and 0.6% of BRCA2 PV carriers at RRSO, with 73% of all tumors originating from the fallopian tube. Older age at RRSO was associated with an increased risk, whereas long-term use of oral contraceptive pill was protective. The authors conclude that these results highlight the importance of timely RRSO with total removal and assessment of the fallopian tubes.