Attitudes toward preventive oophorectomy among BRCAJ mutation carriers in Poland

Currently genetic testing for BRCA1 and BRCA2 susceptibility genes is performed throughout Europe and North America. In Poland three founder mutations in BRCA1 account for 14% of all invasive ovarian cancers and oophorectomy is frequently recommended to mutation carriers as a preventive measure. The purpose of the present study was to evaluate patient acceptance of the recommendation for prophylactic oophorectomy in a hereditary cancer clinic. Seventy-two women over the age of 40 and who carried a BRCA1 mutation were advised to undergo prophylactic oophorectomy. After a mean follow-up period of 19 months, 43 of the women (60%) had undergone the procedure. Of the 29 women who had not had an oophorectomy, five indicated that they did not intend to do so, 19 indicated that they intended to have the operation in the near future and five were undecided. In conclusion, preventive oophorectomy is acceptable to most Polish women at high risk of hereditary ovarian cancer and should be among the range of services offered in cancer genetics clinics.

BRCAI mutation; Prophylactic oophorectomy

[1] Gorski B.. Byrski T.. Huzarski T., Jakubowska A., Menkisiak J., Gronwald J. et al.: "Founder mutations in the BRCAI gene in Polish families with breast-ovarian cancer". Am. J. Hum. Genet., 2000, 66 (6), 1963.

[2] Burke W., Daly M., Garber J., Botkin J.,Lynhn M.J., Lynch P. et al.: "Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II. BRCAI and BRCA2. Cancer Genetics Studies Consortium". JAMA, 1997, 277 (12), 997.

[3] Eisen A.. Rebbeck T.R., Wood W.C.. Weber B.L.: "Prophylactic surgery in women with a hereditary predisposition to breast and ovarian cancer". J. Clin. Oneal., 2000, 18 (9),1980.

[4] Rebbeck TR., Lynch H.T.. Neuhausen S.L., Narod S.A., Van't Veer L., Garber J.E. et al.: "Prophylactic oophorectomy in carriers of BRCAI or BRCA2 mutations". N. Engl. J. Med., 2002. 346 (21), 1616.

[5] Kauff N.D., Satagopan J.M., Robson M.E., Scheuer L., Hensley M.. Hudis C.A. et al.: " Risk-reducing salpingo-oophorectomy in women with a BRCAI or BRCA2 mutation". N. Engl. J. Med., 2002, 346 (21), 1609

[6] Metcalfe K.A., Liede A., Hoodfar E., Scott A.. Foulkes W.D.. Narod S.A.: "An evaluation of needs of female carriers undergoing genetic counselling". J. Med. Genet., 2000, 37 (11), 866.

[7] Wagner T.M., Moslinger R., Langbauer G.. Ahner R.. Fleischmann E.. Auterith A. et al.: "Attitude towards prophylactic surgery and effects of genetic counselling in families with BRCA mutations. Austrian Hereditary Breast and Ovarian Cancer Group". Br. J Cancer, 2000, 82 (7), 1249.

[8] Lodder L.N., Frets P.G., Trijsburg R.W.. Meijers-Heijboer E.J.. Klijn J.G., Seynaeve C. et al.: "One year follow-up of women opting for presymptomatic testing for BRCA I and BRCA2: emotional impact of the test outcome and decisions on risk management (surveillance or prophylactic surgery)". Breast Cancer Res. Treat., 2002, 73 (2), 97.

[9] Lerman C., Hughes C., Croyle R.T.. Main D., Durham C., Snyder D. et al.: "Prophylactic surgery decisions and surveillance pracrices one year following BRCAl/2 testing". Prev. Med., 2000, 31 (1), 75.

[10] Meijers-Heijboer E.J., Verhoog L.C., Brekelmans C.T., Seynaeve C., Tilanus-Linthorst M.M., Wagner A. et al.: "Presymptomatic DNA testing and prophylactic surgery in families with a BRCAI or BRCA2 mutation". Lancet, 2000, 355 (9220), 2015.

[11] Julian-Reynier C.M., Bouchard L.J., Evans D.G., Eisinger F.A., Foulkes W.D., Kerr B.: "Women's attitudes toward preventive surgeries for hereditary breast or ovarian carcinoma differ from one country to another". Cancer, 2001, 92 (4), 959.

[12] Menkiszak J., Gronwald J., Gorski B., Jakubowska A.. Huzarski T., Byrski T. et al.: "Hereditary ovarian cancer in Poland". Int. J. Cancer, 2003, 106 (6), 942.

[13] Warner E., Foulkes W., Goodwin P., Meschino W., Biondal J., Paterson C. et al.: "Prevalence and penetrance of BRCAI and BRCA2 gene mutations in unselected Ashkenazi Jewish women with breast cancer". J. Natl. Cancer Inst., 1999, 91 (14), 1241.

[14] Moslchi R.. Chu W., Karlan B., Fishman D., Risch H., Fields A., et al.: ·'BRCAI and BRCA2 mutation analysis of 208 Ashkenazi Jewish women with ovarian cancer". Am. J. Hum. Genet., 2000, 66 (4), 1259.

[15] Thorlacius S., Struewing J.P., Hartge P., Olaf、dottir G.H.. Sigvaldason H.. Tryggvadottir L. et al.: "Population-based study of risk of breast cancer in carriers of BRCA2 mutation". Lancet, 1998, 352 (9137), 1337.

[16] De Leon Matsuda M.L., Liede A., Kwan E., M apua C.A., Cutiongco E.M., Tan A., Borg A. et al.: "BRCAI and BRCA2 mutations among breast cancer patients from the Philippines". Int. J. Cancer, 2002, 98 (4), 596.

[17] Liede A., Malik I.A.. Aziz Z., Rios Pd Pde L, Kwan E., Narod S.A: "Contribution of BRCAI and BRCA2 mutations to breast and ovarian cancer in Pakistan". Am. J. Hum. Genet., 2002, 71 (3), 595.