Hereditary ovarian cancers: from BRCA mutations to clinical management. A modern appraisal
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In the past few years, ovarian cancer research has focused increasingly on disease prevention; but an increasing number of women refer to gynecology and clinical genetics clinics with a family history of ovarian cancer and inherited familial mutations. The interest on the issue has increased also due to the identification of BReast CAncer1 (BRCA1) and BRCA2 genes mutations. The importance of recognizing the characteristics of hereditary ovarian cancer (HOC) and manage women at risk appropriately will provide more accurate care of the high-risk population. Women at risk can be identified by pedigree analysis and may receive counseling from interdisciplinary cancer genetics clinics, while those at high risk need to receive genetic testing. Risk calculation programs define risks and assist in decision-making in clinical options and genetic testing; they provide information on the risks of the disease, mutation status, and the use of genetic testing in the management of high-risk families. Furthermore, while a large number of surrogate preliminary markers have been identified, there are still limited studies on ovarian cancer genomics. Different options for risk management of HOC are available: surveillance, chemoprevention and prophylactic surgery. Surveillance in HOC high-risk patients is still not accurate. Chemoprevention is currently a controversial topic, because a number of major issues still need to be addressed in developing and testing agents for ovarian cancer chemoprevention. Prophylactic surgery has been shown to effectively decrease cancer risk, and it has the possibility to substantially reduce ovarian cancer mortality.
KeywordsHereditary ovarian cancer BRCA Prophylactic surgery Genetics Genetic testing HNPCC Laparoscopy Oophorectomy Counseling Risk assessment
Prof. Maria Rosaria Buri
Professional Translator/Aiic Conference Interpreter, University Researcher in Translation Studies for her professional supporting in language editing.
Authors certify that there is no actual or potential conflict of interest in relation to this article and (1) all authors of this research paper have directly participated in the planning, execution, or analysis of this study; (2) all authors of this paper have read and approved the final version submitted; (3) the contents of this manuscript have not been copyrighted or published previousl; (4) the contents of this manuscript are not now under consideration for publication elsewhere; (5) the contents of this manuscript will not be copyrighted, submitted, or published elsewhere, while acceptance by the journal is under consideration; and that (6) there are no directly related manuscripts or abstracts, published or unpublished, by any authors of this paper.
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