Page 1 of 3: stumped by gynaec!!

trinity · Credits: 13371 My Scrapbook

which of teh foll strategy has been recomended to reduce teh hereditary risk for ovarian cancer in women with BRCA -1 & BRCA-2 mutations?

1) use of OCPs

2) screening with TVS

3) screening with CA-125

4) prophylactic oophorectomy

Most imp indication for surgical repair of a bicornuate uterus is:

1) infertility

2) dysmenorrhoes

3) menorrhagia

4) habitual abortion??

is it a or d???? Or is someone going to surprise teh hell out of me by saying it one of or c????

AshB · Credits: 41733 My Scrapbook My Reading List 6 Books

Answer to the first question is:... Prophylactic oophorectomy. Various studies affirm that it reduces the risk of future ovarian malignancy by 50%. So it is even performed in young women after coounselling them of its pros n cons.

trinity · Credits: 13371 My Scrapbook

can u give a reference plz ashB??

vimoj · Credits: 27219 My Scrapbook My Reading List 85 Books

habitual abortion

vimoj · Credits: 27219 My Scrapbook My Reading List 85 Books

habitual abortion

hjorq · Credits: 2435 My Scrapbook

even in women who inherit the mutations the risk of cancer is very small.

And going by the theory of Ca Ovary is bcos of repeated injury to ovarian epithelium OCPs shld be the answer.

Had read somewhere that even 6mths of OCP use has a protective effect on ovary.. No ref for this.

AshB · Credits: 41733 My Scrapbook My Reading List 6 Books

Obstet Gynecol. 1992 Oct;80(4):700-7. Related Articles, Links
Comment in: Obstet Gynecol. 1993 Feb;81(2):315-6.

Should women with familial ovarian cancer undergo prophylactic oophorectomy?
Kerlikowske K, Brown JS, Grady DG.
General Internal Medicine Section, Department of Veterans Affairs, San Francisco, California.

OBJECTIVES: To estimate the lifetime probabilities of ovarian cancer in women from families with hereditary ovarian cancer syndromes and those with a family history of ovarian cancer, and to assess the needs for prevention and surveillance in such women. DATA SOURCES: We searched for studies of familial ovarian cancer published since 1966 and used ovarian cancer incidence data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute. METHODS: Pooled estimates of relative risk of ovarian cancer among women with a family history of ovarian cancer were derived using statistical methods based on fixed effects. Modified life-table methods were used to estimate the lifetime probability of ovarian cancer. DATA SYNTHESIS: The lifetime probability of ovarian cancer increases from about 1.6% in a 35-year-old woman without a family history of ovarian cancer to about 5% if she has one relative and 7% if she has two relatives with ovarian cancer. The lifetime probability may decrease to about 3-4% if she takes oral contraceptives for 5-9 years. Women from families with hereditary ovarian cancer syndromes may have as high as a 50% lifetime risk of ovarian cancer. CONCLUSIONS: The risk of ovarian cancer in women from families with hereditary ovarian cancer syndromes is sufficiently high to warrant prophylactic oophorectomy. Among women with one relative with ovarian cancer, the lifetime probability of ovarian cancer is not high enough to recommend oophorectomy. However, some women may choose oophorectomy depending on their attitudes concerning risk-taking, surgery, and hormone replacement. Oral contraceptives should be considered as preventive therapy to decrease the risk of ovarian cancer in women with a family history of ovarian cancer.

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These and many other studies conclude that if BRCA 1 and 2 mutations are positive prophylactic oophorectomy may be better. If only family history is positive (ie. if BRCA status is not mentioned, OCPs may be a better option.)

Well this is what i felt, maybe others might differ.

trinity · Credits: 13371 My Scrapbook

harrison says OCPs!!!! Its in the chapter of gynaecologic malignancies.!

But i'm still confused!

trinity · Credits: 13371 My Scrapbook

hjorq · Credits: 2435 My Scrapbook

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pretty convincing articles. thanks ashb.

Trinity harri says "OCPs reduce the risk of ovarian cancer in pts with familial history and in general population" ... but it does not mention it is better than prophylactic surgery.
Harri also mentions that epithelial tms are commonly seen after age 40 (?? in familial cases also kya?) ...
anyways these facts have me convinced that i screwed up the ans.. i thnk it shld be oophorectomy

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