Precursor Lesions of High-Grade Serous Ovarian Carcinoma: Morphological and Molecular Characteristics

Table 1

Prevalence of occult carcinoma in bilateral prophylactic salpingo-oophorectomy specimens.

Author	Study design	Study population	Sectioning protocol	Findings
Colgan et al. 2001 [15]	Cross-sectional	60 BPSO specimens from women (mean age 48.4) with high likelihood of being BRCA mutation carriers according to family history (early criteria) or tested positive for a BRCA1 or BRCA2 mutation (later criteria)	Ovaries: multiple sections through the short axis; fallopian tubes: 40/60 had representative sections only, the other 20 were completely submitted with transverse sections	5 (8.3%) cases showed occult carcinoma; 4/5 located in fallopian tube
Leeper et al. 2002 [17]	Cross-sectional	30 BPSO specimens from women (mean age 46, range 30–65) at high risk of ovarian cancer according to family or personal history	Ovaries and tubes: first 7 cases had representative sections only, remaining 23 cases were serially sectioned	5 (16.7%) cases showed occult carcinoma; 3 located in fallopian tube
Olivier et al. 2004 [18]	Cross-sectional	38 BPO specimens and 90 BPSO specimens from women (mean age 46, range 26–74) with known BRCA1 or BRCA2 mutations or personal history of breast cancer and family history suggestive of hereditary breast and ovarian cancer	Ovaries from all procedures and tubes from BPSO procedures: sectioned in their entirety	5 (5.6%) cases from BPSO group showed occult carcinoma (all in BRCA1 carriers); 2 restricted to the fallopian tube; no occult cancers in ovary-only specimens
Lamb et al. 2006 [22]	Cross-sectional	113 BPSO specimens from women (median age 47, range 30–70) at high risk for ovarian cancer based on GOG criteria	Ovaries and tubes: sectioned at 2- to 3-mm intervals	7 (6.2%) cases showed ovarian, fallopian tube or peritoneal neoplasia; 5 were early high-grade serous tubal neoplasia
Finch et al. 2006 [21]	Cross-sectional	159 BPSO specimens from BRCA1 or BRCA2 mutation carriers (mean age 47.7, range 34–71)	Ovaries: serially sectioned; fallopian tubes initially representative sections—partway through protocol amended to submit tubes in entirety	7 (4.4%) cases showed occult carcinoma; 6 involved fallopian tube
Medeiros et al. 2006 [25]	Case-control	13 BPSO specimens from BRCA1 or BRCA2 mutation carriers (mean age 50, range 39–76) and 13 controls (mean age 58, range 43–76) undergoing surgery for benign reasons	Ovaries and tubes: sectioned at 2- to 3-mm intervals; fimbriae in some cases serially sectioned, in others by SEE-FIM protocol	5 (38%) cases showed early cancers; all in the fallopian tube; 4/5 stained positive for both p53 and MIB-1, the 5th scored positive for MIB-1 only; no cancers were found in controls
Hermsen et al. 2006 [24]	Case-control	85 BPSO specimens from high-risk women according to family history or BRCA1 or BRCA2 mutation status (median age 48, range 33–64) and 72 controls undergoing surgery for benign reasons (median age 37, range 23–79)	Sectioning details not specified	1 case of tubal carcinoma + 2 cases of severe tubal dysplasia/in situ carcinoma (3.5%) were identified in the BPSO group; no cancers were found in controls
Callahan et al. 2007 [23]	Cross-sectional	122 BPSO specimens from women with BRCA1 or BRCA2 mutations or variants (median age 46.5, range 23–76)	Ovaries and tubes: sectioned at 2- to 3-mm intervals for all cases; SEE-FIM protocol performed in a subset	7 (5.7%) cases showed occult tubal carcinoma
Finch et al. 2006 [13]	Cross-sectional	490 BPSO specimens from women with BRCA1 or BRCA2 mutations (mean age 47.6, range 19–76)	All reported cancers confirmed by review of medical records and/or pathology reports. The pathology reports were reviewed in order to correctly assign the diagnosis of ovarian, fallopian tube, or primary peritoneal cancer.	11 (2.2%) specimens showed occult cancer; 7 were identified as ovarian; 3 were classified as tubal; 1 case had positive peritoneal washings with no source of cancer identified
Powell et al. 2005 [19]	Cross-sectional	67 BPSO specimens from women with BRCA1 or BRCA2 mutations (mean age 47, range 31–64)	Ovaries and tubes: serially sectioned at 2 mm intervals (“full” adherence to specified protocol) in 20 cases; partial adherence in 21 cases; standard procedures (nonadherence) in 26 cases	7 (17%) specimens that were processed by fully or partially adherent protocols (𝑛=41) showed occult cancer; 4 were tubal and 3 were ovarian

BPO: bilateral prophylactic oophorectomy; BPSO: bilateral prophylactic salpingo-oophorectomy; GOG: gynecologic oncology group; SEE-FIM: sectioning and extensively examining the fimbriae.