http://archsurg.jamanetwork.com/ en-us Fri, 01 Mar 2013 00:00:00 GMT Tue, 26 Mar 2013 21:46:27 GMT Silverchair editor@archsurg.jamanetwork.com webmaster@archsurg.jamanetwork.com http://archsurg.jamanetwork.com/article.aspx?articleID=1670350 Fri, 01 Mar 2013 00:00:00 GMT Keung EZ, Ashley SW. <span class="paragraphSection">Women with inherited BRCA1/2 mutations have substantially elevated risks of breast and ovarian cancer, with 60% to 85% cumulative lifetime risk of invasive breast cancer and 10% to 63% risk of ovarian cancer. Prophylactic mastectomy and risk-reducing bilateral salpingo-oophorectomy (RRBSO) reduce the risk of both cancers and of cancer-specific and all-cause mortality in these patients.</span> 148 3 291 291 10.1001/jamasurg.2013.1025 http://archsurg.jamanetwork.com/article.aspx?articleID=1670350 http://archsurg.jamanetwork.com/article.aspx?articleID=1670368 Fri, 01 Mar 2013 00:00:00 GMT Sitzmann JV, Wiebke EA. <span class="paragraphSection">Risk-reducing bilateral salpingo-oophorectomy (RRBSO) and risk-reducing mastectomy are widely used for BRCA1 and BRCA2 mutation carriers to reduce the risk of ovarian and breast cancer. To our knowledge, no risk-reduction therapy has addressed the BCRA1/2 carrier lifetime risk of intra-abdominal peritoneal carcinoma from an appendix source. We identified a BRCA1 carrier in a hereditary breast and ovarian cancer kindred who developed a low-grade malignant appendiceal mucocele 2 years after risk-reducing salpingo-oophorectomy. Our retrospective meta-analysis assessed the risk of intraperitoneal appendiceal cancer in BRCA1/2 carriers after RRBSO to determine whether elective risk-reduction appendectomy could reduce the incidence of intraperitoneal cancer. Data sources included the case report and 12 reports of BRCA1 and BRCA2 carriers after RRBSO with ovarian, fallopian tube, breast, and peritoneal cancer published from January 1, 1985, through April 30, 2012. Main outcome measures were nonovarian, non–fallopian tube, nonbreast, positive intra-abdominal peritoneal carcinoma in previously cancer-free BRCA1/2 carriers after RRBSO. The source of intraperitoneal cancer in BRCA1/2 carriers after risk-reducing salpingo-oophorectomy is highly likely the appendix. Use of risk-reduction appendectomy with RRBSO in younger BRCA1/2 carriers may reduce lifetime risk of malignant tumor and eliminate intraperitoneal cancer.</span> 148 3 285 291 10.1001/jamasurg.2013.1006 http://archsurg.jamanetwork.com/article.aspx?articleID=1670368