A recent prospective study of patients with mutations in the BRCA1 gene indicated that ultrasound screening was not an effective alternative to oophorectomy in preventing ovarian cancer. Results were reported in Gynecologic Oncology.

In this study, conducted in Poland, researchers monitored 1964 women with BRCA1 mutations. At the start of the study, each participant had 2 intact ovaries and no history of ovarian or fallopian cancer. The researchers evaluated health events that occurred among participants during the study period, including ultrasound screenings to detect ovarian cancer and occurrences of cancer or death.

After a mean study follow-up of 7.3 years, a total of 1196 participants had underwent ultrasound screenings only, 41 underwent preventive oophorectomies only, 618 underwent both, and 109 had neither.

There were 73 cancers of ovarian, fallopian, or peritoneal origin recorded within the group of women who received only ultrasound screenings, and 27 patients died of ovarian or fallopian cancer in this group.

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Among 659 women who underwent preventive oophorectomy with or without ultrasound screening, 12 cases of cancer of ovarian, fallopian, or peritoneal origin occurred, with 2 fatalities from among these cancer types. Nine of these 12 cancers were discovered upon oophorectomy.

The researchers suggested that in women with BRCA1 mutations, salpingo-oophorectomy should occur prior to age 40 years.

“In conclusion, this observational study of transvaginal ultrasound, preventive oophorectomy, and ovarian cancer mortality in BRCA1 [mutation] carriers suggests that, at present, ultrasound screening is not a rational alternative to preventive salpingo-oophorectomy,” wrote the study authors in their report.

Reference

Gronwald J, Lubinski J, Huzarski T, et al. A comparison of ovarian cancer mortality in women with BRCA1 mutations undergoing annual ultrasound screening or preventive oophorectomy [published online September 6, 2019]. Gynecol Oncol. doi: 10.1016/j.ygyno.2019.08.034