Hereditary ovarian/breastcancers(HOC/HBOC)
Chair and Department of Surgical Gynecologyand Gynecological Oncology
of Adults and Adolescents.
Head: Prof. zw. dr hab. n. med.
Izabella Rzepka–Górska
HOC - SSHBOC (~80%)
Definitive criteriafor HOC
at least 3 relatives
with ovarian cancer
one of them is I0 or II0relative for two others
Criteria for
high probability
HOC
1/ two ovarian cancer
diagnosed in I0 or II0
(any age)
2/ one ovarian cancer(diagnosed in any age) andpatients second primary
breast cancer or
breast cancer diagnosed
before the age of 50 years
in I0 or II0 relatives
Clinicalcharacteristics
of
HOC
I group HOC – pedigree criteria(patients with ovarian cancer)
II group HOC –
patients with ovarian cancerand
detected founder mutation of
BRCA1 gene
Age at diagnosis
(of ovarian cancer)
HOC - 51,6 yrs
HOC(BRCA1+) - 51,44 yrs
Age at diagnosis
(of ovarian cancer)
in Norway
HBOC(BRCA1+) - 51,5 yrs
Borg et al.
Age at diagnosis
(of ovarian cancer)
56 - 61 yrs
(in generalpopulations)
FIGO staging - III0 & IV0
(of ovarian cancer)
HOC – 86,36%
HOC (BRCA1+) – 83,87%
FIGO staging - III0 & IV0
(of ovarian cancer)
in Norway
HBOC(BRCA1+) - 81,82%
Borg et al.
Morphological grading -G3
(of ovarian cancer)
HOC – 81,25%
HOC (BRCA1+) – 73,91%
Morphological grading -G3
(of ovarian cancer)
in Norway
HBOC(BRCA1+) - 82%
Borg et al.
Histopathologicaltype - serous
(of ovarian cancer)
HOC – 86,36%
HOC(BRCA1+) – 80,77%
Histopathologicaltype - serous
(of ovarian cancer)
in Norway
HBOC(BRCA1+) - 91%
Borg et al.
BRCA1
(ovarian cancer)
46 - 50 - III/IV - 3
D N A
testing
IHCC POLANDHead: Prof. dr habil. n.med. Jan Lubiński16 january 20073718 - BRCA1Mutations CarriersThe largest registry in the world
IN POLAND
13.5% of ovariancancer develop inBRCA1
mutation carriers
Frequency of BRCA1 mutations in series of consecutiveovarian cancers from different populations
POPULATION
Frequency of mutations
%
n
ASHKENAZI JEWISH
35,5
27,5
67/189
57/208
POLISH
13,5
49/364
PAKISTANI
13,3
16/120
HUNGARIAN
11,1
10/90
USA
8,6
10/116
CANADIAN
7,6
39/515
FRENCH CANADIAN
5,1
5/99
FINNISH
4,7
11/233
JAPANESE
4,0
3/76
BRITISH
3,4
12/355
NORWEGIAN
3,3
2/60
Now we have
the question?
What we can do
with membershereditarycancer families?
S c r e e n i ng
1/ IntravaginalUSG+ CA 125- beginning 20 -25(yrs) Interval 6(months)
Female genitaltract screeningby TV USG detectsonly10%of early ovariancancerNAROD S.A. ONTARIO1999
What yet
we cando?
2/ werecommend
(patients with BRCA mutationcarriers)
Prophylactic
adnexectomy andhysterectomy
at the
completion ofchildbearing
> 40 yrs of age.
Prophylacticoperations
in our Clinic
1 january 2007 - 125
I N C I D E N C E
Every
ovarian andbreast cancer
– indication for
B R C A testing