BRCA Carriers Have More Premalignant Adnexal Lesions

However, women unlikely to have premalignant lesions in both breast and ovarian tissue

THURSDAY, Sept. 7 (HealthDay News) -- An inherited risk for breast and ovarian cancer is associated with a greater likelihood of premalignant lesions in the breast or adnexa, but no higher risk for simultaneous occurrence of premalignant lesions in both areas of the body, according to a study in the September issue of the International Journal of Cancer.

Brenda B.J. Hermsen, M.D., of the VU University Medical Centre in Amsterdam, the Netherlands, and colleagues evaluated tissue from 85 women who had prophylactic bilateral salpingo-oophorectomy and 59 women who had prophylactic mastectomy and compared them with tissue from healthy controls undergoing breast reduction or ovarian surgery for benign reasons.

Women older than 40 years with a BRCA1 or a BRCA2 mutation had a 50 percent prevalence of premalignant adnexal lesions; the prevalence was 14 percent in those younger than 40. None of the women over 40 with a BRCA mutation had premalignant breast lesions, compared with 47 percent of women without a BRCA1/2 mutation. Two of 23 women age 40 or younger had a premalignant breast lesion and both were BRCA1/2 mutation carriers. The 28 women who had surgery on both organs were more likely to have adnexal lesions than breast lesions.

"Our study did not support the hypothesis of concomitant occurrence of premalignant lesions in both organs in women at hereditary high risk of breast and ovarian cancers. The high frequency of (pre)malignant lesions in the adnexal tissue stresses further the importance of prophylactic bilateral salpingo-oophorectomy from the age of 40 onwards in women at hereditary high risk," the authors write.

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