The characteristics and associations of pelvic pain in gynecologiccancer patients: A single institution studyC. Craiga, S.J. Gibsonb, K.E. Osannc, J. Farleya, L. Willmotta, B.J. Monka,D.M. Chasea. aSt. Joseph's Hospital and Medical Center, Phoenix, AZ,USA, bUniversity of Arizona, Tuscon, AZ, USA, cUniversity of CaliforniaIrvine, Irvine, CA, USA.

Objectives: To explore the incidence and characteristics of pelvicpain in cancer patients attending a single institution cancer center.Methods: A cross-sectional study was undertaken consisting of a six-page survey distributed to a random sample of patients attendingthis comprehensive cancer center. The survey contained anonymousself-reported demographic, treatment, lifestyle characteristics, Qual-ity of Life (QOL), and pelvic pain inquiries that were randomlydistributed to cancer patients. The QOL data collected was theFunctional Assessment of Cancer Therapy — General (FACT-G) inaddition to a previously validated female pelvic pain survey. FACT-Gand Pain scores, along with subdomains, were compared by patientdescriptive variables (exercise, diet, BMI, stage, disease status,treatment) using two-group t-tests or Analysis of Variance.Results: Over the course of 1 year, 124 cancer patients completed thissurvey of which 105 were female and thus completed the pelvic painsurvey. 68% (N= 68) of patients who completed the pelvic pain survey(N= 100) had gynecologic cancers. The non-gynecologic cancersrepresented included brain, breast, colon, and esophageal cancers. Themajority of patientswere in the 61–70 age range,with roughly 80% beingEnglish-speaking (N= 83). Approximately half of the patients reportedreceiving chemotherapy and/or radiation. The stages were distributed asfollows however 32% (N= 35) of patients did not report a stage: 23%stage I, 24% stage II, 34% stage III, 19% stage IV. 25% of the patients reportnever exercising and 50% report eating 1–2 servings of fruits and/orvegetables per day. Of a total possible score of 45 and individual totalscores of 23, 10 and 12 for pain, urinary andQOL impact respectively, thisgroup of patients had a mean overall score of 12.30 (±9.48) with 4.75(±5.66), 2.27 (±2.48) and 5.40 (±3.61) for pain, urinary and QOLimpact subscales. In multivariate analysis pelvic pain (P b 0.0005) andless exercise (P = 0.01) were associated with poorer QOL. In this groupof patients, pelvic pain was more likely to be associated with thegynecologic cancer patients (P b 0.05) and in patientswith a BMI N 30. Inaddition the pelvic pain scores were significantly associated withindividual quartiles of the FACT-G (P = 0.0001).Conclusions: Data collected in this study demonstrates thatpelvic pain scores are poor in this population. Pelvic pain is associatedwith infrequent exercise, poor QOL, gynecologic cancers, and higherBMI. There is a direct correlation of pelvic pain to the FACT-G totalscores.

doi:10.1016/j.ygyno.2013.07.045

Patterns of breast cancer surveillance and breast cancer detectionin women with serous ovarian/tubal or peritoneal carcinomaswho have had brca mutation testingDaniel Paik, Farin Amersi, Alexandra Gangi, Catherine Dang, BethKarlan, Ronald Leuchter, Andrew Li, Christine Walsh, B.J. Rimel, IlanaCass. Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Objectives: To compare the frequency and histopathologic featuresof breast cancer following serous ovarian/tubal or peritoneal canceramong women with and without germline BRCA mutations and tocompare breast cancer surveillance patterns between these cohorts.Methods:An IRB approved retrospective reviewofwomenwith invasiveserous ovarian/tubal or peritoneal carcinomas who had BRCA mutationtesting in our Gynecologic Oncology and Breast Centers patient registriesfrom 1998 to 2012. Demographic and surgicopathologic data was

collected. Breast cancer surveillance patterns between BRCA mutationcarriers and wild type patients were compared.Results: 379 women with gynecologic cancer had BRCA testing:152(40%) had BRCA mutations and 227 (60%) were wild type.12/152(8%) BRCA mutation carriers developed subsequent breastcancer compared to 3/227 (1%) BRCA wild type patients (p b 0.001).Of the 12 BRCA-associated breast cancers 7 had BRCA 1, 4 had BRCA2and 1 had both mutations (Figure 1). The primary site and stage of thegynecologic cancer or use of adjuvant chemotherapy had no impact onthe frequency of subsequent breast cancer. Cancer relatedmortalitywasdue to gynecologic cancer with the exception of a single patient withtubal carcinoma who died from metastatic breast cancer. MMG postgynecologic cancer was the most common breast cancer surveillanceused in 75% of BRCA mutation carriers versus 36% in wild type patients(p b 0.001). Of note, 50% of the BRCA carriers underwent breast MRIsurveillance and 10% used tamoxifen or aromatase inhibitors for breastcancer prevention. Breast cancer surveillance was discontinued inpatients with a disease-free interval of b12 months. 13/152 (9%) ofBRCA mutation carriers had prophylactic mastectomy at a median of23 months following gynecologic cancer diagnosis.Conclusions: Breast cancer following ovarian/tubal or peritonealserous cancer occurs more commonly among BRCA mutationcarriers, but is rarely the cause of mortality. Mammogram detectedthe majority of the breast cancers at early stage.

BRCA-associatedbreast cancerN = 12

BRCA wild typebreast cancerN = 3

Median time between gyn andbreast cancer dx (in yrs)

6 1

Initial detectionClinical breast exam 3 (25%) 0Mammogram (MMG) 7 (58%) 3 (100%)Prophylactic mastectomy 2 (17%) 0

HistologyDCIS 4 0Infiltrating ductal carcinoma 8 3

Stage breast cancerStage 1 6 2Stage 2 2 1

Triple negative ER/PR/Her-2 neu 5 (63%) 2 (50%)

doi:10.1016/j.ygyno.2013.07.046

Adjuvant radiation for high grade histology, early stage (FIGO IA)endometrial cancer improves local controlD. Lya, B.D. Rowleyb, M.K. Dodsonc, A.P. Soissonc, C. Jollesd, W.T.Sausee. aHuntsman Cancer Institute, University of Utah, Department ofRadiation Oncology, Salt Lake City, UT, USA, bIntermountain Healthcare,Oncology Clinical Program, Salt Lake City, UT, USA, cHuntsman CancerInstitute, University of Utah, Salt Lake City, UT, USA, dSpecial Gynecologyand Oncology, Riverton, UT, USA, eIntermountain Medical Center,Radiation Oncology, Salt Lake City, UT, USA.

Objectives: To determine the effect of adjuvant radiation on localrecurrence for high grade histology, early stage (FIGO IA) endome-trial cancer.Methods: We retrospectively identified 86 patients who had ahysterectomy for early stage (FIGO IA), high grade histology (clearcell, serous papillary or endometrioid adenocarcinoma grade 3)endometrial cancer treated between 1992 and 2010. Adjuvantradiation started within 120 days. Patients were restaged accordingto current FIGO 2009 guidelines. Exclusion criteria included uterinesarcoma histology, prior diagnosis of other cancer, or previous pelvicradiation. Primary endpoint is for local control (defined as recurrent

Abstracts / Gynecologic Oncology 131 (2013) 248–276264