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Objectives: The natural history and optimal management of
serous tubal intraepithelial carcinoma (STIC), regardless of BRCA
status, is unknown. We report the follow-up findings of a series of
incidental fallopian tube high-grade serous carcinomas (HGSCs) and STICs
identified in women at low risk for hereditary breast and ovarian
cancer (HBOC), undergoing surgery for other indications.
Materials and Methods: Cases of incidental STIC and HGSC
were identified from 2008. Patients with known BRCA1 or BRCA2 mutations,
or a family history of ovarian or breast cancer before the diagnosis of
STIC or HGSC were excluded. A retrospective chart review was conducted
to obtain clinical data.
Results: Eighteen cases were identified with a median
follow-up of 25 months (range, 4-88 months). Twelve of 18 patients had a
diagnosis of STIC with no associated invasive HGSC and 6 had STIC
associated with other invasive malignancies. Completion staging surgery
was performed on 7 of the 18 patients, including 5 of 12 in which there
was STIC only identified on primary surgery; 3 cases were upstaged from
STIC only to HGSC based on the staging surgery. Recurrence of HGSC
occurred in 2 of the 18 patients. BRCA testing was performed on 3
patients, 1 of whom tested positive for a pathogenic BRCA1 mutation.
Conclusions: Our study suggests that completion staging
surgery for incidental STICs in non-BRCA patients may be considered.
These patients should be offered hereditary testing. The Pelvic-Ovarian
cancer INTerception (POINT) Project is an international registry set up
to add to our understanding of STICs.