Hereditary ovarian/breast cancers (HOC/HBOC) Chair and Department of Surgical Gynecology and Gynecological Oncology of Adults and Adolescents. Head: Prof

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  • Hereditary ovarian/breast cancers (HOC/HBOC) Chair and Department of Surgical Gynecology and Gynecological Oncology of Adults and Adolescents. Head: Prof. zw. dr hab. n. med. Izabella RzepkaGrska
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  • HOC - SS HBOC (~80%)
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  • Definitive criteria for HOC
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  • at least 3 relatives with ovarian cancer one of them is I 0 or II 0 relative for two others
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  • Criteria for high probability HOC
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  • 1/ two ovarian cancer diagnosed in I 0 or II 0 (any age)
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  • 2/ one ovarian cancer (diagnosed in any age) and patients second primary breast cancer or breast cancer diagnosed before the age of 50 years in I 0 or II 0 relatives
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  • Clinical characteristics of HOC
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  • I group HOC pedigree criteria (patients with ovarian cancer)
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  • II group HOC patients with ovarian cancer and detected founder mutation of BRCA1 gene
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  • Age at diagnosis (of ovarian cancer) HOC - 51,6 yrs HOC (BRCA1+) - 51,44 yrs
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  • Age at diagnosis (of ovarian cancer) in Norway HBOC (BRCA1+) - 51,5 yrs Borg et al.
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  • Age at diagnosis (of ovarian cancer) 56 - 61 yrs (in general populations)
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  • FIGO staging - III 0 & IV 0 (of ovarian cancer) HOC 86,36% HOC (BRCA1+) 83,87%
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  • FIGO staging - III 0 & IV 0 (of ovarian cancer) in Norway HBOC (BRCA1+) - 81,82% Borg et al.
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  • Morphological grading - G3 (of ovarian cancer) HOC 81,25% HOC (BRCA1+) 73,91%
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  • Morphological grading - G3 (of ovarian cancer) in Norway HBOC (BRCA1+) - 82% Borg et al.
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  • Histopathological type - serous (of ovarian cancer) HOC 86,36% HOC (BRCA1+) 80,77%
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  • Histopathological type - serous (of ovarian cancer) in Norway HBOC (BRCA1+) - 91% Borg et al.
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  • BRCA1 (ovarian cancer ) 46 - 50 - III/IV - 3
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  • D N A testing
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  • IHCC POLAND Head: Prof. dr habil. n. med. Jan Lubi ski 16 january 200 7 3718 - BRCA1 Mutations Carriers The largest registry in the world
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  • IN POLAND 13.5% of ovarian cancer develop in BRCA1 mutation carriers
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  • Frequency of BRCA1 mutations in series of consecutive ovarian cancers from different populations POPULATION Frequency of mutations %n ASHKENAZI JEWISH35,5 27,5 67/189 57/208 POLISH13,549/364 PAKISTANI13,316/120 HUNGARIAN11,110/90 USA8,610/116 CANADIAN7,639/515 FRENCH CANADIAN5,15/99 FINNISH4,711/233 JAPANESE4,03/76 BRITISH3,412/355 NORWEGIAN3,32/60
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  • Now we have the question?
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  • What we can do with members hereditary cancer families ?
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  • S c r e e n i ngS c r e e n i ng
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  • 1/ Intravaginal USG + CA 125 - beginning 20 - 25(yrs) Interval 6 (months)
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  • Female genital tract screening by TV USG detects only 10% of early ovarian cancer NAROD S.A. ONTARIO 1999
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  • What yet we can do?
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  • 2/ we recommend (patients with BRCA mutation carriers) Prophylactic adnexectomy and hysterectomy at the completion of childbearing > 40 yrs of age.
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  • Prophylactic operations in our Clinic 1 january 2007 - 125
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  • I N C I D E N C EI N C I D E N C E
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  • Every ovarian and breast cancer indication for B R C A testing