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Management of Preinvasive Lesions
Maria G Patrono1, Camila Corzo, Maria Iniesta
1*Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina †Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Clinical Obstetrics and Gynecology
|September 29, 2017
Summary
Serous tubal intraepithelial carcinoma (STIC) is a precursor to high-grade serous carcinoma. Finding STIC, especially in BRCA1/2 mutation carriers, necessitates genetic counseling and may require further cancer management strategies.
Area of Science:
- Gynecologic Oncology
- Cancer Genetics
- Pathology
Background:
- Serous tubal intraepithelial carcinoma (STIC) is the established precursor lesion for high-grade serous carcinoma (HGSC).
- STIC is identified in both low-risk and high-risk populations, including individuals with BRCA1/2 mutations.
- In BRCA1/2 mutation carriers undergoing risk-reducing surgery, incidental STICs are found in approximately 2% of cases.
Purpose of the Study:
- To review the clinical implications and management of incidental serous tubal intraepithelial carcinoma (STIC).
- To emphasize the importance of genetic counseling and potential hereditary cancer program referral upon STIC discovery.
Main Methods:
- Review of literature concerning STIC detection and management.
- Analysis of patient outcomes following incidental STIC diagnosis, particularly in BRCA1/2 mutation carriers.
Main Results:
- Even after risk-reducing salpingo-oophorectomy, the risk of developing primary peritoneal carcinoma post-STIC detection remains significant (up to 7.5%).
- Current postoperative recommendations for incidental STICs are not standardized, with options including surgical staging, adjuvant chemotherapy, or observation.
Conclusions:
- Discovery of STIC warrants consideration for referral to a hereditary cancer program for BRCA1/2 mutation screening.
- Management strategies for incidental STICs require further clarification and standardization to optimize patient outcomes.
