BRCA GEN MUTASYONU NEDENİYLE PROFİLAKTİK JİNEKOLOJİK CERRAHİ UYGULANAN OLGULARIN DEĞERLENDİRİLMESİ

Abstract

EYUPOGLU, M. Evaluation of Cases Undergoing Prophylactic Gynecological Surgery Due to BRCA Gene Mutation, Hacettepe University Faculty Of Medicine, Department Of Obstetrics And Gynecology Residency Thesis, Ankara 2022. BRCA gene mutation and awareness is one of the reasons for increasing admission in gynecology outpatient clinics over the years. As in other hereditary cancer genes, BRCA gene mutation can cause cancer at an early age compared to the general population, especially in breast and ovary, prostate, pancreas, melanoma and rarely in other locations. The aim of this retrospective clinical study is to determine the parameters that may affect the decision mechanism in the process from diagnosis to treatment, to compare the predictive values of these parameters and to determine the demographic characteristics of patients who applied to our gynecology outpatient clinic due to BRCA gene mutation and underwent prophylactic gynecological surgery between 2016-2021. The study population consisted of 31 patients with 12 BRCA1 and 19 BRCA2 gene mutations. It was observed that the majority of the patients (80.6%) applied to us after a history of breast cancer. When the postoperative pathology results of the patients were examined, no malignant precursor lesion was found. While benign pathologies were observed in 16 (51.6%) patients, no lesion was found in 15 (48.4%) patients. No peritoneal cancer was detected during the mean follow-up period of 35.3 ± 22.9 months. In the group of patients with a history of breast cancer, estrogen receptor status was predominantly negative in patients with BRCA1 mutation compared to BRCA2 mutations (p=0,02). Postmenopausal patients preferred prophylactic gynecological surgery faster than premenopausal patients (p=0,014). Patients with a family history of 1st or 2nd degree relatives with breast or ovarian cancer were diagnosed with breast cancer at an earlier age (p=0,037), diagnosed with BRCA gene mutation earlier (p=0,021) and had earlier prophylactic surgery (p=0,020). In conclusion, prophylactic gynecological surgery in patients with BRCA gene mutation is seen as an effective clinical approach that reduces the risk of cancer development. Key Words: BRCA, Hereditary Breast and Ovarian Cancer, Prophylactic Surgery