Article Database

Primary Peritoneal Carcinoma in a BRCA1/2-negative, PALB2-positive patient

Abstract:

Primary Peritoneal Carcinoma (PPC) is a cancer of the abdominal peritoneal lining without involvement of the ovaries or identifiable primary tumor. Its estimated annual incidence in the United States is 0.46 per 100,000 women(Goodman et al., 2009). The actual incidence of low-grade serous PPC is much lower (< 1/150,000) (Rothacker et al., 1995). Most cases are serous subtype with cellular origin identical to that of epithelial ovarian carcinoma. PPC often mimics ovarian and fallopian tube cancers. It accounts for roughly 10% of ovarian carcinomas that have been presumably misdiagnosed (Rothacker et al., 1995).

Women undergoing prophylactic bilateral salpingo-oophorectomy (BSO) can still develop PPC years later, suggesting that certain epithelial peritoneal cancers do not originate from the ovarian surface. Instead, ovarian epithelial tumors and PPC are hypothesized to share a common embryologic origin with similar germline and somatic mutations. In current literature, nearly all PPC cases have been reported in women with a known BRCA1/2 germline mutation. However, there have been minimal studies on genetic testing outside of BRCA1/2 mutations in patients with PPC. Here, we report a case of a BRCA1/2-negative patient who had undergone prophylactic BSO and presented years later with PPC and was subsequently found to carry a mutation in PALB2.

Presentation, treatment, and outcomes of Haitian women with breast cancer in Miami and Haiti: Disparities in breast cancer—a retrospective cohort study

Abstract:

Purpose: We compared a cohort of Haitian immigrants with residents in Haiti with breast cancer (BC) to evaluate the effects of location on presentation, treatment, and outcomes.

Patients and methods: Participants were Haitian women with BC living in Miami who presented to the University of Miami/Jackson Memorial Hospital and women with BC living in Haiti who presented to the Innovating Health International Women’s Cancer Center. The primary outcome was the relationship between location, cancer characteristics, and survival. The secondary objective was to compare our results with data extracted from the SEER database. Cox regression was used to compare survival.

Results: One hundred two patients from University of Miami/Jackson Memorial Hospital and 94 patients from Innovating Health International were included. The patients in Haiti, compared with the patients in Miami, were younger (mean age, 50.2 v 53.7 years, respectively; P = .042), presented after a longer duration of symptoms (median, 20 v 3 months, respectively; P < .001), had more advanced stage (44.7% v 25.5% with stage III and 27.6% v 18.6% with stage IV BC, respectively), and had more estrogen receptor (ER) -negative tumors (44.9% v 26.5%, respectively; P = .024). The percentage of women who died was 31.9% in Haiti died compared with 17.6% in Miami. Median survival time was 53.7 months for women in Haiti and was not reached in Miami. The risk of death was higher for women in Haiti versus women in Miami (adjusted hazard ratio, 3.09; P = .0024).

Conclusion: Women with BC in Haiti experience a significantly worse outcome than immigrants in Miami, which seems to be related to a more advanced stage and younger age at diagnosis, more ER-negative tumors, and lack of timely effective treatments. The differences in age and ER status are not a result of access to care and are unexplained.

Precursors of High-Grade Serous Carcinoma

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Ovarian cancer: the fallopian tube as the site of origin and opportunities for prevention

Abstract:

High-grade serous carcinoma (HGSC) is the most common and aggressive histotype of epithelial ovarian cancer (EOC), and it is the predominant histotype associated with hereditary breast and ovarian cancer syndrome (HBOC). Mutations in BRCA1 and BRCA2 are responsible for most of the known causes of HBOC, while mutations in mismatch repair genes and several genes of moderate penetrance are responsible for the remaining known hereditary risk. Women with a history of familial ovarian cancer or with known germline mutations in highly penetrant genes are offered the option of risk-reducing surgery that involves the removal of the ovaries and fallopian tubes (salpingo-oophorectomy). Growing evidence now supports the fallopian tube epithelia as an etiological site for the development of HGSC and consequently, salpingectomy alone is emerging as a prophylactic option. This review discusses the site of origin of EOC, the rationale for risk-reducing salpingectomy in the high-risk population, and opportunities for salpingectomy in the low-risk population.

New biological research and understanding of Papanicolaou’s test

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Mismatch repair (MMR) screening among minority women with endometrial cancer

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Objective: Immunohistochemistry (IHC) for mismatch repair (MMR) proteins has been incorporated for initial Lynch syndrome (LS) screening in endometrial cancer. The majority of LS studies have predominantly included non-Hispanic white women, with few examining MMR screening in minority women. The objective of this study was to evaluate universal MMR screening in a predominantly minority patient population.

MYC Gene Amplification in High-Grade Serous Ovarian Carcinoma and its Association with BRCA1/2 Mutation Status

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Not available at this time.

Meeting report from the 2018 12th Biennial Ovarian Cancer Research Symposium detection and prevention of ovarian cancer

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Loss of LKB1 and p53 synergizes to alter fallopian tube epithelial phenotype and high-grade serous tumorigenesis

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In vivo and ex vivo approaches to study ovarian cancer metastatic colonization of milky spot structures in peritoneal adipose

Abstract:

High-grade serous ovarian cancer (HGSC), the cause of widespread peritoneal metastases, continues to have an extremely poor prognosis; fewer than 30% of women are alive 5 years after diagnosis. The omentum is a preferred site of HGSC metastasis formation. Despite the clinical importance of this microenvironment, the contribution of omental adipose tissue to ovarian cancer progression remains understudied. Omental adipose is unusual in that it contains structures known as milky spots, which are comprised of B, T, and NK cells, macrophages, and progenitor cells surrounding dense nests of vasculature. Milky spots play a key role in the physiologic functions of the omentum, which are required for peritoneal homeostasis. We have shown that milky spots also promote ovarian cancer metastatic colonization of peritoneal adipose, a key step in the development of peritoneal metastases. Here we describe the approaches we developed to evaluate and quantify milky spots in peritoneal adipose and study their functional contribution to ovarian cancer cell metastatic colonization of omental tissues both in vivo and ex vivo. These approaches are generalizable to additional mouse models and cell lines, thus enabling the study of ovarian cancer metastasis formation from initial localization of cells to milky spot structures to the development of widespread peritoneal metastases.