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Hereditary ovarian / breast cancers (HOC /HBOC )

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 Rzepka–Górska. HOC - SS HBOC (~80%). Def initive criteria for HOC. at least 3 relatives

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Hereditary ovarian / breast cancers (HOC /HBOC )

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  1. Hereditary ovarian/breast cancers (HOC/HBOC) Chair andDepartmentof Surgical Gynecology and Gynecological Oncology of Adults and Adolescents. Head:Prof. zw. dr hab. n. med. Izabella Rzepka–Górska

  2. HOC - SSHBOC (~80%)

  3. Definitive criteria for HOC

  4. at least 3 relatives with ovarian cancer one of them is I0 or II0 relative for two others

  5. Criteria for high probability HOC

  6. 1/two ovarian cancer diagnosed in I0 or II0 (any age)

  7. 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 I0 or II0 relatives

  8. Clinical characteristics of HOC

  9. I group HOC– pedigreecriteria(patients with ovarian cancer)

  10. II group HOC – patients with ovarian cancerand detected founder mutation of BRCA1 gene

  11. Age at diagnosis (of ovariancancer) HOC - 51,6 yrs HOC(BRCA1+) - 51,44yrs

  12. Age at diagnosis (of ovariancancer) in Norway HBOC(BRCA1+) - 51,5 yrs Borg et al.

  13. Age at diagnosis (of ovariancancer) 56 - 61 yrs (in general populations)

  14. FIGO staging- III0 & IV0 (of ovariancancer) HOC – 86,36% HOC(BRCA1+) – 83,87%

  15. FIGO staging- III0 & IV0 (of ovariancancer) in Norway HBOC(BRCA1+) - 81,82% Borg et al.

  16. Morphological grading - G3 (of ovariancancer) HOC – 81,25% HOC(BRCA1+) – 73,91%

  17. Morphological grading - G3 (of ovariancancer) in Norway HBOC(BRCA1+) - 82% Borg et al.

  18. Histopathological type -serous (of ovarian cancer) HOC – 86,36% HOC(BRCA1+) – 80,77%

  19. Histopathological type -serous (of ovariancancer) in Norway HBOC(BRCA1+) - 91% Borg et al.

  20. BRCA1 (ovarian cancer) 46 - 50 - III/IV - 3

  21. DNA testing

  22. IHCC POLANDHead:Prof. dr habil. n. med. JanLubiński16 january 20073718 - BRCA1 Mutations CarriersThe largest registry in the world

  23. IN POLAND 13.5% of ovarian cancer develop in BRCA1 mutation carriers

  24. Frequency of BRCA1 mutations in series of consecutive ovarian cancers from different populations

  25. Now we have thequestion?

  26. What we can do with members hereditary cancer families ?

  27. Screening

  28. 1/Intravaginal USG + CA 125 - beginning  20 - 25(yrs) Interval 6 (months)

  29. Female genital tract screening by TV USG detects only 10%of early ovarian cancerNAROD S.A. ONTARIO 1999

  30. What yet we can do?

  31. 2/we recommend (patients with BRCA mutation carriers) Prophylactic adnexectomy and hysterectomy at the completion of childbearing > 40 yrs of age.

  32. Prophylactic operations in our Clinic 1 january2007 - 125

  33. INCIDENCE

  34. Every ovarian and breast cancer – indication for BRCAtesting

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