Prophylactic Gynecologic Specimens from Hereditary Cancer Carriers

Surg Pathol Clin. 2016 Jun;9(2):307-28. doi: 10.1016/j.path.2016.02.002.

Abstract

Hereditary breast ovarian cancer and Lynch/hereditary nonpolyposis colorectal cancer syndrome account for most hereditary gynecologic cancers. In the absence of effective cancer screening and other preventative strategies, risk-reducing surgery in women who are known to be at genetic risk of BRCA-associated or of Lynch syndrome carcinomas is effective in significantly decreasing the lifetime risk of developing malignancy. Reflex genomic testing of high-grade ovarian cancers and reflex immunohistochemistry in endometrial cancers will lead to greater recognition of germline-associated cancers. Approaches to processing surgical specimens, the recognition and classification of cancer precursor lesions, and differentiation from their mimics are discussed.

Keywords: BRCA; Endometrial cancer; Hereditary cancer; Lynch syndrome; Ovarian cancer; Prophylactic surgery; Risk-reducing salpingectomy; Salpingo-oophorectomy.

Publication types

  • Review

MeSH terms

  • BRCA2 Protein / genetics
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / prevention & control
  • Female
  • Genetic Predisposition to Disease
  • Hereditary Breast and Ovarian Cancer Syndrome / diagnosis
  • Hereditary Breast and Ovarian Cancer Syndrome / genetics
  • Hereditary Breast and Ovarian Cancer Syndrome / pathology
  • Hereditary Breast and Ovarian Cancer Syndrome / prevention & control*
  • Humans
  • Hysterectomy
  • Lynch Syndrome II / diagnosis
  • Lynch Syndrome II / genetics
  • Lynch Syndrome II / pathology
  • Lynch Syndrome II / prevention & control*
  • Mutation
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / prevention & control
  • Ovariectomy
  • Precancerous Conditions / diagnosis
  • Precancerous Conditions / surgery
  • Salpingectomy / methods
  • Ubiquitin-Protein Ligases / genetics

Substances

  • BRCA2 Protein
  • BRCA2 protein, human
  • BRAP protein, human
  • Ubiquitin-Protein Ligases