Fallopian tube often site of malignancies related to BRCA mutations

September 19, 2007

NEW YORK (Reuters Health) - In BRCA-positive women undergoing surgery for ovarian cancer risk reduction, the distal fallopian tube appears to be the dominant site of origin of early malignancies, researchers report in the September 1st issue of the Journal of Clinical Oncology.

"This study clearly demonstrates the importance of removing the fallopian tube when performing prophylactic surgery," senior investigator Dr. Michael G. Muto told Reuters Health. It "highlights how critical it is for pathologists to comprehensively examine the fallopian tube."

Dr. Muto of Brigham and Women's Hospital, Boston and colleagues came to this conclusion after examining the records of 122 patients who had undergone such surgery between 1999 and 2007.

Seven of the patients (5.7%) had malignancies discovered at the time of surgery, and all were in the fimbrial or ampullary region of the tube. Six had an early epithelial component, indicative of metastatic potential.

In light of these findings, the researchers conclude that in such patients, the "greatest proportion of serous cancer risk should be assigned to the fimbria rather than the ovary." They call for particular vigilance in examining the fimbria.

Moreover, added Dr. Muto, "The fascinating question this study raises, is whether cancers we think are ovarian in origin may in fact start in the adjacent tube."