Hereditary ovarian cancer

Ovarian cancer ranks sixth as the most common cancer and fifth as the most deadly malignancy among women worldwide. In addition, it places third among the most common gynecological cancers. Which proves that it is a significant medical problem worldwide. Most ovarian cancers (75-90%) are sporadic and arise from the accumulation of somatic mutations that are confined to the genome of the tumor tissue. However, about 10-25% of all ovarian cancer cases are hereditary. Most hereditary cases of ovarian cancer are associated with one of three genetic syndromes: hereditary breast and ovarian cancer syndrome (HBOC), hereditary ovarian site-specific cancer syndrome (HOC-ss) and hereditary non-polyposis-related colorectal cancer syndrome (HNPCC). Mutations in the BRCA1/BRCA2 underlie the majority of hereditary ovarian cancers and belong to the group of genes with high penetrance which means that carriers of their pathogenic variants have a high risk of developing ovarian cancer. Mutations in these genes are inherited in an autosomal dominant disorder, which means that inheriting a single copy of the mutated gene significantly increases the risk of developing this cancer. In contrast, about 5-10% of patients are carriers of pathogenic variants in other genes with moderate or low penetrance, such as ATM, CHEK2, PALB2 or BARD1. More than 75% of all ovarian cancers are detected at FIGO stages III and IV, in which the overall 5-year survival does not exceed 35%. Ovarian cancer is a heterogeneous disease that understanding the hereditary basis of this disease is crucial for its effective diagnosis, management and prevention. This review article aims to discuss the genetic basis of hereditary ovarian cancer, epidemiology, etiology and treatment options.