Risk-Reducing Surgeries in Gynecological Cancers: A Review of the Current State
Yıl 2024,
Cilt: 57 Sayı: 2, 74 - 78, 31.08.2024
Bilal Esat Temiz
,
Utku Akgör
Öz
Risk-reducing surgery has an important role to play in the prevention of gynaecological cancers, particularly in women who are at high risk of these cancers. Risk-reducing bilateral salpingo-oophorectomy (rrBSO) has been shown to significantly reduce the risk of ovarian and fallopian tube cancers and all-cause mortality in women with BRCA1/2 mutations. Combined prophylactic hysterectomy and bilateral salpingo-oophorectomy is recommended for patients with Lynch syndrome and has been shown to reduce the risk of endometrial and ovarian cancer. Although long-term data are needed, opportunistic salpingectomy is considered to be an effective method of reducing the risk of epithelial ovarian cancer. Based on genetic mutations and individual risk factors, risk-reducing surgery for gynaecological cancers is an important component of personalised treatment plans. The aim of this review is to provide a comprehensive analysis of the different surgical strategies associated with BRCA1/2 mutations, Lynch syndrome and other hereditary conditions. It evaluates the role and potential benefits of surgical interventions such as risk-reducing bilateral salpingo-oophorectomy (rrBSO), prophylactic hysterectomy and opportunistic salpingectomy in clinical practice, and assesses their efficacy and feasibility.
Kaynakça
- 1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics
2022: GLOBOCAN estimates of incidence and mortality worldwide
for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-
263. doi:10.3322/caac.21834
- 2. Iijima M, Banno K, Okawa R, et al. Genome-wide analysis
of gynecologic cancer: The Cancer Genome Atlas in ovarian and endometrial
cancer. Oncol Lett. 2017;13(3):1063-1070. doi:10.3892/
ol.2017.5582
- 3. NCCN Guidelines. Available online: https://www.nccn.org/
professionals/physician_gls/pdf/genetics_bop.pdf (accessed on 20
November 2022)
- 4. Petrucelli N, Daly MB, Pal T. BRCA1- and BRCA2-Associated
Hereditary Breast and Ovarian Cancer. In: Adam MP, Feldman J,
Mirzaa GM, et al, eds. Seattle: GeneReviews: University of Washington;
1993.
- 5. Conte C, Pelligra S, Sarpietro G, et al. Hereditary Women’s
Cancer: Management and Risk-Reducing Surgery. Medicina
(Kaunas). 2023;59(2):300. doi:10.3390/medicina59020300
- 6. Evans O, Gaba F, Manchanda R. Population-based genetic
testing for Women’s cancer prevention. Best Practice & Research
Clinical Obstetrics & Gynaecology. 2020;65:139-153. doi:https://doi.
org/10.1016/j.bpobgyn.2020.02.007
- 7. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks
of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1
and BRCA2 Mutation Carriers. Jama. 2017;317(23):2402-2416.
doi:10.1001/jama.2017.7112
- 8. Marchetti C, De Felice F, Palaia I, et al. Risk-reducing salpingo-
oophorectomy: a meta-analysis on impact on ovarian cancer
risk and all cause mortality in BRCA 1 and BRCA 2 mutation carriers.
BMC Womens Health. 2014;14:150. doi:10.1186/s12905-014-0150-
5
- 9. Boyd J, Sonoda Y, Federici MG, et al. Clinicopathologic
features of BRCA-linked and sporadic ovarian cancer. JAMA.
2000;283(17):2260-5. doi:10.1001/jama.283.17.2260
- 10. Antoniou A, Pharoah PD, Narod S, et al. Average risks of
breast and ovarian cancer associated with BRCA1 or BRCA2 mutations
detected in case Series unselected for family history: a combined
analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117-30.
doi:10.1086/375033
- 11. King MC, Marks JH, Mandell JB. Breast and ovarian cancer
risks due to inherited mutations in BRCA1 and BRCA2. Science.
2003;302(5645):643-6. doi:10.1126/science.1088759
- 12. Daly MB, Pal T, Berry MP, et al. Genetic/Familial High-Risk
Assessment: Breast, Ovarian, and Pancreatic, Version 2.2021, NCCN
Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw.
2021;19(1):77-102. doi:10.6004/jnccn.2021.0001
- 13. Kauff ND, Domchek SM, Friebel TM, et al. Risk-reducing
salpingo-oophorectomy for the prevention of BRCA1- and
BRCA2-associated breast and gynecologic cancer: a multicenter,
prospective study. J Clin Oncol. 2008;26(8):1331-7. doi:10.1200/
jco.2007.13.9626
- 14. Society of Gynecologic Oncologists Clinical Practice Committee
Statement on Prophylactic Salpingo-oophorectomy. Gynecol
Oncol. 2005;98(2):179-81. doi:10.1016/j.ygyno.2005.05.002
- 15. Kurman RJ, Shih Ie M. The origin and pathogenesis of epithelial
ovarian cancer: a proposed unifying theory. Am J Surg Pathol.
2010;34(3):433-43. doi:10.1097/PAS.0b013e3181cf3d79
- 16. Kwon JS, Tinker A, Pansegrau G, et al. Prophylactic salpingectomy
and delayed oophorectomy as an alternative for BRCA mutation carriers. Obstet Gynecol. 2013;121(1):14-24. doi:10.1097/
aog.0b013e3182783c2f
- 17. Lugo Santiago N, Smith E, Cox M, et al. Ovarian Cancer
After Prophylactic Salpingectomy in a Patient With Germline
BRCA1 Mutation. Obstet Gynecol. 2020;135(6):1270-4. doi:10.1097/
aog.0000000000003864
- 18. SGO clinical practice statement: Salpingectomy for ovarian
cancer prevention. Available at: www.sgo.org/clinical practice/
guidelines/sgo-clinical-practice-statement salpingectomy-for-ovarian-
cancer-prevention/ (Accessed on December 11, 2019).
- 19. National Comprehensive Cancer Network (NCCN) guidelines.
Genetic/Familial High-Risk Assessment: Breast, Ovarian, and
Pancreatic, version 3.2024. Available at: https://www.nccn.org/
guidelines/guidelines-detail?category=2&id=1503 (Accessed on
April 17, 2024).
- 20. Dowdy SC, Stefanek M, Hartmann LC. Surgical risk reduction:
prophylactic salpingo-oophorectomy and prophylactic mastectomy.
Am J Obstet Gynecol. 2004;191(4):1113-23. doi:10.1016/j.
ajog.2004.04.028
- 21. Kauff ND, Barakat RR. Surgical risk-reduction in carriers
of BRCA mutations: where do we go from here? Gynecol Oncol.
2004;93(2):277-9. doi:10.1016/j.ygyno.2004.03.016
- 22. Alvarado-Cabrero I, Young RH, Vamvakas EC, Scully RE.
Carcinoma of the fallopian tube: a clinicopathological study of 105
cases with observations on staging and prognostic factors. Gynecol
Oncol. 1999;72(3):367-79. doi:10.1006/gyno.1998.5267
- 23. Sherman ME, Piedmonte M, Mai PL, et al. Pathologic
findings at risk-reducing salpingo-oophorectomy: primary results
from Gynecologic Oncology Group Trial GOG-0199. J Clin Oncol.
2014;32(29):3275-83. doi:10.1200/jco.2013.54.1987
- 24. Owens DK, Davidson KW, Krist AH, et al. Risk Assessment,
Genetic Counseling, and Genetic Testing for BRCA-Related Cancer:
US Preventive Services Task Force Recommendation Statement.
Jama. 2019;322(7):652-65. doi:10.1001/jama.2019.10987
- 25. Kauff ND, Satagopan JM, Robson ME, et al. Risk-reducing
salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation.
N Engl J Med. 2002;346(21):1609-15. doi:10.1056/NEJMoa020119
- 26. Paley PJ, Swisher EM, Garcia RL, et al. Occult cancer of the
fallopian tube in BRCA-1 germline mutation carriers at prophylactic
oophorectomy: a case for recommending hysterectomy at surgical
prophylaxis. Gynecol Oncol. 2001;80(2):176-80. doi:10.1006/
gyno.2000.6071
- 27. Rebbeck TR, Kauff ND, Domchek SM. Meta-analysis of risk
reduction estimates associated with risk-reducing salpingo-oophorectomy
in BRCA1 or BRCA2 mutation carriers. J Natl Cancer Inst.
2009;101(2):80-7. doi:10.1093/jnci/djn442
- 28. Chai X, Domchek S, Kauff N, Rebbeck T, Chen J. RE: Breast
Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation
Carriers: Revisiting the Evidence for Risk Reduction. J Natl
Cancer Inst. 2015;107(9):djv217. doi:10.1093/jnci/djv217
- 29. Arora S, Yelikar BR, Karigoudar MH. Evaluation of SEE-FIM
(Sectioning and Extensively Examining the FIMbriated End) Protocol
in Identifying Fallopian Tube Precursor Lesions in Women with
Ovarian Tumors. J Obstet Gynaecol India. 2019;69(Suppl 2):153-9.
doi:10.1007/s13224-018-1155-z
- 30. Koc N, Ayas S, Arinkan SA. Comparison of the Classical
Method and SEE-FIM Protocol in Detecting Microscopic Lesions in
Fallopian Tubes with Gynecological Lesions. J Pathol Transl Med.
2018;52(1):21-7. doi:10.4132/jptm.2016.06.17
- 31. Garrett LA, Growdon WB, Goodman A, Boruta DM, Schorge
JO, del Carmen MG. Endometriosis-associated ovarian malignancy: a retrospective analysis of presentation, treatment, and outcome. J
Reprod Med. 2013;58(11-12):469-76.
- 32. Yoon SH, Kim SN, Shim SH, Kang SB, Lee SJ. Bilateral salpingectomy
can reduce the risk of ovarian cancer in the general population:
A meta-analysis. Eur J Cancer. 2016;55:38-46. doi:10.1016/j.
ejca.2015.12.003
- 33. Pölcher M, Hauptmann S, Fotopoulou C, et al. Opportunistic
salpingectomies for the prevention of a high-grade serous carcinoma:
a statement by the Kommission Ovar of the AGO. Arch Gynecol
Obstet. 2015;292(1):231-4. doi:10.1007/s00404-015-3697-y
- 34. de Jonge MM, de Kroon CD, Jenner DJ, et al. Endometrial
Cancer Risk in Women With Germline BRCA1 or BRCA2 Mutations:
Multicenter Cohort Study. J Natl Cancer Inst. 2021;113(9):1203-11.
doi:10.1093/jnci/djab036
- 35. Obermair A, Youlden DR, Baade PD, Janda M. The impact
of risk-reducing hysterectomy and bilateral salpingo-oophorectomy
on survival in patients with a history of breast cancer--a population-
based data linkage study. Int J Cancer. 2014;134(9):2211-22.
doi:10.1002/ijc.28537
- 36. Moreira L, Balaguer F, Lindor N, et al. Identification of
Lynch syndrome among patients with colorectal cancer. JAMA.
2012;308(15):1555-65. doi:10.1001/jama.2012.13088
- 37. Schmeler KM, Lynch HT, Chen LM, et al. Prophylactic surgery
to reduce the risk of gynecologic cancers in the Lynch syndrome.
N Engl J Med. 2006;354(3):261-9. doi:10.1056/NEJMoa052627
- 38. Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL,
Burt RW. ACG clinical guideline: Genetic testing and management
of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol.
2015;110(2):223-62; quiz 263. doi:10.1038/ajg.2014.435
- 39. Giardiello FM, Allen JI, Axilbund JE, et al. Guidelines on genetic
evaluation and management of Lynch syndrome: a consensus
statement by the US Multi-society Task Force on colorectal cancer.
Am J Gastroenterol. 2014;109(8):1159-79. doi:10.1038/ajg.2014.186
- 40. Vasen HF, Blanco I, Aktan-Collan K, et al. Revised guidelines
for the clinical management of Lynch syndrome (HNPCC): recommendations
by a group of European experts. Gut. 2013;62(6):812-
23. doi:10.1136/gutjnl-2012-304356
- 41. Stoffel EM, Mangu PB, Gruber SB, et al. Hereditary colorectal
cancer syndromes: American Society of Clinical Oncology Clinical
Practice Guideline endorsement of the familial risk-colorectal cancer:
European Society for Medical Oncology Clinical Practice Guidelines.
J Clin Oncol. 2015;33(2):209-17. doi:10.1200/jco.2014.58.1322
- 42. https://www.nccn.org/professionals/physician_gls/pdf/genetics_
colon.pdf (Accessed on April 08, 2019).
- 43. National Comprehensive Cancer Network (NCCN) guidelines.
Genetic/Familial High-Risk Assessment: Breast, Ovarian, and
Pancreatic, version 3.2024. Available at: https://www.nccn.org/
guidelines/guidelines-detail?category=2&id=1503 (Accessed on
April 17, 2024).
Jinekolojik Kanserlerde Risk Azaltıcı Cerrahiler: Güncel Duruma Bakış
Yıl 2024,
Cilt: 57 Sayı: 2, 74 - 78, 31.08.2024
Bilal Esat Temiz
,
Utku Akgör
Öz
Risk azaltıcı cerrahi, özellikle yüksek risk altındaki kadınlarda jinekolojik kanserlerin önlenmesinde önemli bir rol oynamaktadır. Risk azaltıcı bilateral salpingo-ooferektomi (rrBSO), BRCA1/2 mutasyonları taşıyan kadınlarda over ve fallop tüpü kanserlerine bağlı mortalite riskini anlamlı şekilde azaltmaktadır. Lynch sendromu olan hastalarda kombine profilaktik histerektomi ve bilateral salpingo-ooferektomi önerilmektedir ve bu yaklaşımın endometriyal ve over kanseri riskini azalttığı gösterilmiştir. Uzun dönem verilerine ihtiyaç duyulmasına rağmen, fırsatçı salpenjektomi, epitelyal over kanseri riskini azaltmada etkili bir yöntem olarak değerlendirilmektedir. Genetik mutasyonlar ve bireysel risk faktörlerine dayanarak, jinekolojik kanserler için risk azaltıcı cerrahi, kişiselleştirilmiş tedavi planlarının önemli bir bileşeni olarak kabul edilmektedir. Bu derleme, BRCA1/2 mutasyonları, Lynch sendromu ve diğer kalıtsal durumlarla ilişkili çeşitli cerrahi stratejileri kapsamlı bir şekilde analiz etmeyi amaçlamaktadır. rrBSO, profilaktik histerektomi ve oportunistik salpenjektomi gibi cerrahi müdahalelerin etkinliğini ve uygulanabilirliğini değerlendirerek, bu prosedürlerin klinik pratikteki rolünü ve potansiyel yararlarını incelemeyi amaçlamaktadır.
Teşekkür
Saygıdeğer Prof. Dr. M. Recep PEKCİCİ tarafından davet ile yazdığımız derleme için kendisine teşekkürlerimizi sunarız.
Kaynakça
- 1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics
2022: GLOBOCAN estimates of incidence and mortality worldwide
for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-
263. doi:10.3322/caac.21834
- 2. Iijima M, Banno K, Okawa R, et al. Genome-wide analysis
of gynecologic cancer: The Cancer Genome Atlas in ovarian and endometrial
cancer. Oncol Lett. 2017;13(3):1063-1070. doi:10.3892/
ol.2017.5582
- 3. NCCN Guidelines. Available online: https://www.nccn.org/
professionals/physician_gls/pdf/genetics_bop.pdf (accessed on 20
November 2022)
- 4. Petrucelli N, Daly MB, Pal T. BRCA1- and BRCA2-Associated
Hereditary Breast and Ovarian Cancer. In: Adam MP, Feldman J,
Mirzaa GM, et al, eds. Seattle: GeneReviews: University of Washington;
1993.
- 5. Conte C, Pelligra S, Sarpietro G, et al. Hereditary Women’s
Cancer: Management and Risk-Reducing Surgery. Medicina
(Kaunas). 2023;59(2):300. doi:10.3390/medicina59020300
- 6. Evans O, Gaba F, Manchanda R. Population-based genetic
testing for Women’s cancer prevention. Best Practice & Research
Clinical Obstetrics & Gynaecology. 2020;65:139-153. doi:https://doi.
org/10.1016/j.bpobgyn.2020.02.007
- 7. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks
of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1
and BRCA2 Mutation Carriers. Jama. 2017;317(23):2402-2416.
doi:10.1001/jama.2017.7112
- 8. Marchetti C, De Felice F, Palaia I, et al. Risk-reducing salpingo-
oophorectomy: a meta-analysis on impact on ovarian cancer
risk and all cause mortality in BRCA 1 and BRCA 2 mutation carriers.
BMC Womens Health. 2014;14:150. doi:10.1186/s12905-014-0150-
5
- 9. Boyd J, Sonoda Y, Federici MG, et al. Clinicopathologic
features of BRCA-linked and sporadic ovarian cancer. JAMA.
2000;283(17):2260-5. doi:10.1001/jama.283.17.2260
- 10. Antoniou A, Pharoah PD, Narod S, et al. Average risks of
breast and ovarian cancer associated with BRCA1 or BRCA2 mutations
detected in case Series unselected for family history: a combined
analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117-30.
doi:10.1086/375033
- 11. King MC, Marks JH, Mandell JB. Breast and ovarian cancer
risks due to inherited mutations in BRCA1 and BRCA2. Science.
2003;302(5645):643-6. doi:10.1126/science.1088759
- 12. Daly MB, Pal T, Berry MP, et al. Genetic/Familial High-Risk
Assessment: Breast, Ovarian, and Pancreatic, Version 2.2021, NCCN
Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw.
2021;19(1):77-102. doi:10.6004/jnccn.2021.0001
- 13. Kauff ND, Domchek SM, Friebel TM, et al. Risk-reducing
salpingo-oophorectomy for the prevention of BRCA1- and
BRCA2-associated breast and gynecologic cancer: a multicenter,
prospective study. J Clin Oncol. 2008;26(8):1331-7. doi:10.1200/
jco.2007.13.9626
- 14. Society of Gynecologic Oncologists Clinical Practice Committee
Statement on Prophylactic Salpingo-oophorectomy. Gynecol
Oncol. 2005;98(2):179-81. doi:10.1016/j.ygyno.2005.05.002
- 15. Kurman RJ, Shih Ie M. The origin and pathogenesis of epithelial
ovarian cancer: a proposed unifying theory. Am J Surg Pathol.
2010;34(3):433-43. doi:10.1097/PAS.0b013e3181cf3d79
- 16. Kwon JS, Tinker A, Pansegrau G, et al. Prophylactic salpingectomy
and delayed oophorectomy as an alternative for BRCA mutation carriers. Obstet Gynecol. 2013;121(1):14-24. doi:10.1097/
aog.0b013e3182783c2f
- 17. Lugo Santiago N, Smith E, Cox M, et al. Ovarian Cancer
After Prophylactic Salpingectomy in a Patient With Germline
BRCA1 Mutation. Obstet Gynecol. 2020;135(6):1270-4. doi:10.1097/
aog.0000000000003864
- 18. SGO clinical practice statement: Salpingectomy for ovarian
cancer prevention. Available at: www.sgo.org/clinical practice/
guidelines/sgo-clinical-practice-statement salpingectomy-for-ovarian-
cancer-prevention/ (Accessed on December 11, 2019).
- 19. National Comprehensive Cancer Network (NCCN) guidelines.
Genetic/Familial High-Risk Assessment: Breast, Ovarian, and
Pancreatic, version 3.2024. Available at: https://www.nccn.org/
guidelines/guidelines-detail?category=2&id=1503 (Accessed on
April 17, 2024).
- 20. Dowdy SC, Stefanek M, Hartmann LC. Surgical risk reduction:
prophylactic salpingo-oophorectomy and prophylactic mastectomy.
Am J Obstet Gynecol. 2004;191(4):1113-23. doi:10.1016/j.
ajog.2004.04.028
- 21. Kauff ND, Barakat RR. Surgical risk-reduction in carriers
of BRCA mutations: where do we go from here? Gynecol Oncol.
2004;93(2):277-9. doi:10.1016/j.ygyno.2004.03.016
- 22. Alvarado-Cabrero I, Young RH, Vamvakas EC, Scully RE.
Carcinoma of the fallopian tube: a clinicopathological study of 105
cases with observations on staging and prognostic factors. Gynecol
Oncol. 1999;72(3):367-79. doi:10.1006/gyno.1998.5267
- 23. Sherman ME, Piedmonte M, Mai PL, et al. Pathologic
findings at risk-reducing salpingo-oophorectomy: primary results
from Gynecologic Oncology Group Trial GOG-0199. J Clin Oncol.
2014;32(29):3275-83. doi:10.1200/jco.2013.54.1987
- 24. Owens DK, Davidson KW, Krist AH, et al. Risk Assessment,
Genetic Counseling, and Genetic Testing for BRCA-Related Cancer:
US Preventive Services Task Force Recommendation Statement.
Jama. 2019;322(7):652-65. doi:10.1001/jama.2019.10987
- 25. Kauff ND, Satagopan JM, Robson ME, et al. Risk-reducing
salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation.
N Engl J Med. 2002;346(21):1609-15. doi:10.1056/NEJMoa020119
- 26. Paley PJ, Swisher EM, Garcia RL, et al. Occult cancer of the
fallopian tube in BRCA-1 germline mutation carriers at prophylactic
oophorectomy: a case for recommending hysterectomy at surgical
prophylaxis. Gynecol Oncol. 2001;80(2):176-80. doi:10.1006/
gyno.2000.6071
- 27. Rebbeck TR, Kauff ND, Domchek SM. Meta-analysis of risk
reduction estimates associated with risk-reducing salpingo-oophorectomy
in BRCA1 or BRCA2 mutation carriers. J Natl Cancer Inst.
2009;101(2):80-7. doi:10.1093/jnci/djn442
- 28. Chai X, Domchek S, Kauff N, Rebbeck T, Chen J. RE: Breast
Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation
Carriers: Revisiting the Evidence for Risk Reduction. J Natl
Cancer Inst. 2015;107(9):djv217. doi:10.1093/jnci/djv217
- 29. Arora S, Yelikar BR, Karigoudar MH. Evaluation of SEE-FIM
(Sectioning and Extensively Examining the FIMbriated End) Protocol
in Identifying Fallopian Tube Precursor Lesions in Women with
Ovarian Tumors. J Obstet Gynaecol India. 2019;69(Suppl 2):153-9.
doi:10.1007/s13224-018-1155-z
- 30. Koc N, Ayas S, Arinkan SA. Comparison of the Classical
Method and SEE-FIM Protocol in Detecting Microscopic Lesions in
Fallopian Tubes with Gynecological Lesions. J Pathol Transl Med.
2018;52(1):21-7. doi:10.4132/jptm.2016.06.17
- 31. Garrett LA, Growdon WB, Goodman A, Boruta DM, Schorge
JO, del Carmen MG. Endometriosis-associated ovarian malignancy: a retrospective analysis of presentation, treatment, and outcome. J
Reprod Med. 2013;58(11-12):469-76.
- 32. Yoon SH, Kim SN, Shim SH, Kang SB, Lee SJ. Bilateral salpingectomy
can reduce the risk of ovarian cancer in the general population:
A meta-analysis. Eur J Cancer. 2016;55:38-46. doi:10.1016/j.
ejca.2015.12.003
- 33. Pölcher M, Hauptmann S, Fotopoulou C, et al. Opportunistic
salpingectomies for the prevention of a high-grade serous carcinoma:
a statement by the Kommission Ovar of the AGO. Arch Gynecol
Obstet. 2015;292(1):231-4. doi:10.1007/s00404-015-3697-y
- 34. de Jonge MM, de Kroon CD, Jenner DJ, et al. Endometrial
Cancer Risk in Women With Germline BRCA1 or BRCA2 Mutations:
Multicenter Cohort Study. J Natl Cancer Inst. 2021;113(9):1203-11.
doi:10.1093/jnci/djab036
- 35. Obermair A, Youlden DR, Baade PD, Janda M. The impact
of risk-reducing hysterectomy and bilateral salpingo-oophorectomy
on survival in patients with a history of breast cancer--a population-
based data linkage study. Int J Cancer. 2014;134(9):2211-22.
doi:10.1002/ijc.28537
- 36. Moreira L, Balaguer F, Lindor N, et al. Identification of
Lynch syndrome among patients with colorectal cancer. JAMA.
2012;308(15):1555-65. doi:10.1001/jama.2012.13088
- 37. Schmeler KM, Lynch HT, Chen LM, et al. Prophylactic surgery
to reduce the risk of gynecologic cancers in the Lynch syndrome.
N Engl J Med. 2006;354(3):261-9. doi:10.1056/NEJMoa052627
- 38. Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL,
Burt RW. ACG clinical guideline: Genetic testing and management
of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol.
2015;110(2):223-62; quiz 263. doi:10.1038/ajg.2014.435
- 39. Giardiello FM, Allen JI, Axilbund JE, et al. Guidelines on genetic
evaluation and management of Lynch syndrome: a consensus
statement by the US Multi-society Task Force on colorectal cancer.
Am J Gastroenterol. 2014;109(8):1159-79. doi:10.1038/ajg.2014.186
- 40. Vasen HF, Blanco I, Aktan-Collan K, et al. Revised guidelines
for the clinical management of Lynch syndrome (HNPCC): recommendations
by a group of European experts. Gut. 2013;62(6):812-
23. doi:10.1136/gutjnl-2012-304356
- 41. Stoffel EM, Mangu PB, Gruber SB, et al. Hereditary colorectal
cancer syndromes: American Society of Clinical Oncology Clinical
Practice Guideline endorsement of the familial risk-colorectal cancer:
European Society for Medical Oncology Clinical Practice Guidelines.
J Clin Oncol. 2015;33(2):209-17. doi:10.1200/jco.2014.58.1322
- 42. https://www.nccn.org/professionals/physician_gls/pdf/genetics_
colon.pdf (Accessed on April 08, 2019).
- 43. National Comprehensive Cancer Network (NCCN) guidelines.
Genetic/Familial High-Risk Assessment: Breast, Ovarian, and
Pancreatic, version 3.2024. Available at: https://www.nccn.org/
guidelines/guidelines-detail?category=2&id=1503 (Accessed on
April 17, 2024).