{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:39:03Z","timestamp":1792481943171,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Risk\u2010reducing salpingo\u2010oophorectomy is the standard intervention for prevention of tubo\u2010ovarian carcinoma in women with pathogenic\n BRCA1<\/jats:italic>\n \/2 variants, yet the optimal timing remains clinically challenging, particularly for\n BRCA2<\/jats:italic>\n carriers.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed 329 clinically asymptomatic\n BRCA1\/2<\/jats:italic>\n carriers who underwent prophylactic gynecologic surgery with sectioning and extensively examining the fimbria (SEE\u2010FIM) protocol histopathologic assessment at two Czech tertiary centers between November 2014 and September 2024. The primary outcome was occult malignant or premalignant pathology, defined as serous tubal intraepithelial carcinoma (STIC) or invasive high\u2010grade serous carcinoma (HGSC). The cohort included 211\n BRCA1<\/jats:italic>\n and 118\n BRCA2<\/jats:italic>\n carriers.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 10 occult lesions were detected (3.0%, 95% confidence interval 1.7\u20135.5): five STIC lesions (1.5%) and five occult HGSCs (1.5%). Among\n BRCA1<\/jats:italic>\n carriers, eight lesions were identified (3.8%), including all five STIC lesions and three HGSCs. Among\n BRCA2<\/jats:italic>\n carriers, two occult HGSCs were detected (1.7%), both after the age of 55\u2009years, and no STIC was found. The difference in any occult lesion between\n BRCA1<\/jats:italic>\n and\n BRCA2<\/jats:italic>\n carriers was not statistically significant (\n p<\/jats:italic>\n \u2009=\u20090.504), but lesion numbers were small. Occult HGSC occurred at an older age than did STIC (median 55.0 vs. 43.0\u2009years;\n p<\/jats:italic>\n \u2009=\u20090.012). In exploratory analyses, a family history of breast cancer and ever smoking were associated with occult lesions, including in a reduced multivariable model, but these findings require cautious interpretation because of the sparse number of events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n These data support meticulous pathologic evaluation and individualized counseling. The absence of early\n BRCA2<\/jats:italic>\n \u2010associated occult lesions should be considered hypothesis generating and should not be interpreted as evidence for delaying risk\u2010reducing salpingo\u2010oophorectomy beyond current recommendations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ijgo.71411","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:52:59Z","timestamp":1792479179000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occult serous tubal intraepithelial carcinoma and high\u2010grade serous carcinoma at risk\u2010reducing salpingo\u2010oophorectomy in\n \n BRCA1<\/i>\n <\/scp>\n \/2 carriers: A Czech two\u2010center cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7185-550X","authenticated-orcid":false,"given":"Olga","family":"Zikan Dubova","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, First Faculty of Medicine Charles University and Bulovka University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8295-290X","authenticated-orcid":false,"given":"Lukas","family":"Dostalek","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine Charles University and General University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5948-735X","authenticated-orcid":false,"given":"Michal","family":"Emingr","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine Charles University and General University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8900-8057","authenticated-orcid":false,"given":"Munachiso","family":"Ndukwe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Hradec Kralove Hradec Kralove Czech Republic"},{"name":"Department of Obstetrics and Gynecology Charles University, Faculty of Medicine in Hradec Kralove Hradec Kralove Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5266-8895","authenticated-orcid":false,"given":"Michal","family":"Zikan","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, First Faculty of Medicine Charles University and Bulovka University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20040952"},{"issue":"10022","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/S0140-6736(15)01224-6","article-title":"Ovarian cancer screening and mortality in the UK collaborative trial of ovarian cancer screening (UKCTOCS): a randomised controlled trial","volume":"387","author":"Jacobs IJ","year":"2016","journal-title":"Lancet"},{"issue":"23","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1001\/jama.2017.7112","article-title":"Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers","volume":"317","author":"Kuchenbaecker KB","year":"2017","journal-title":"JAMA"},{"issue":"9","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1001\/jama.2010.1237","article-title":"Association of risk\u2010reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality","volume":"304","author":"Domchek SM","year":"2010","journal-title":"JAMA"},{"issue":"15","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1200\/JCO.2013.53.2820","article-title":"Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation","volume":"32","author":"Finch AP","year":"2014","journal-title":"J Clin Oncol"},{"key":"e_1_2_11_8_1","unstructured":"National Cancer Institute.BRCA1 and BRCA2: Cancer Risks and Management (PDQ)\u2010Health Professional Version.2025."},{"issue":"5","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ajog.2021.06.070","article-title":"Uptake and timing of risk\u2010reducing salpingo\u2010oophorectomy among patients with BRCA1 and BRCA2 mutations","volume":"225","author":"Smith MJ","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1200\/OP.21.00382","article-title":"Risk\u2010reducing bilateral salpingo\u2010oophorectomy for ovarian cancer: a review and clinical guide for hereditary predisposition genes","volume":"18","author":"Liu YL","year":"2022","journal-title":"JCO Oncol Pract"},{"issue":"25","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"3985","DOI":"10.1200\/JCO.2007.12.2622","article-title":"Primary fallopian tube malignancies in BRCA\u2010positive women undergoing surgery for ovarian cancer risk reduction","volume":"25","author":"Callahan MJ","year":"2007","journal-title":"J Clin Oncol"},{"issue":"1","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ejca.2012.07.021","article-title":"Support of the fallopian tube hypothesis in a prospective series of risk\u2010reducing salpingo\u2010oophorectomy specimens","volume":"49","author":"Reitsma W","year":"2013","journal-title":"Eur J Cancer"},{"issue":"1","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1200\/JCO.2005.04.109","article-title":"Risk\u2010reducing salpingo\u2010oophorectomy in BRCA mutation carriers: role of serial sectioning in the detection of occult malignancy","volume":"23","author":"Powell CB","year":"2005","journal-title":"J Clin Oncol"},{"issue":"29","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"3275","DOI":"10.1200\/JCO.2013.54.1987","article-title":"Pathologic findings at risk\u2010reducing salpingo\u2010oophorectomy: primary results from gynecologic oncology group trial GOG\u20100199","volume":"32","author":"Sherman ME","year":"2014","journal-title":"J Clin Oncol"},{"issue":"4","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00428-021-03244-w","article-title":"Recommendations for diagnosing STIC: a systematic review and meta\u2010analysis","volume":"480","author":"Bogaerts JMA","year":"2022","journal-title":"Virchows Arch"},{"issue":"1","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ejso.2019.09.002","article-title":"Pathological findings following risk\u2010reducing salpingo\u2010oophorectomy in BRCA mutation carriers: a systematic review and meta\u2010analysis","volume":"46","author":"Cheng A","year":"2020","journal-title":"Eur J Surg Oncol"},{"issue":"14","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1200\/JCO.22.01237","article-title":"High\u2010grade serous carcinoma at risk\u2010reducing salpingo\u2010oophorectomy in asymptomatic carriers of BRCA1\/2 pathogenic variants: prevalence and clinical factors","volume":"41","author":"Stroot IAS","year":"2023","journal-title":"J Clin Oncol"},{"issue":"2","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ygyno.2016.08.336","article-title":"Occult and subsequent cancer incidence following risk\u2010reducing surgery in BRCA mutation carriers","volume":"143","author":"Zakhour M","year":"2016","journal-title":"Gynecol Oncol"},{"issue":"2","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.ygyno.2019.03.003","article-title":"Retrospective study of a 16 year cohort of BRCA1 and BRCA2 carriers presenting for RRSO: prevalence of invasive and in\u2010situ carcinoma, with follow\u2010up","volume":"153","author":"Blok F","year":"2019","journal-title":"Gynecol Oncol"}],"container-title":["International Journal of Gynecology & Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71411","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71411","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:53:07Z","timestamp":1792479187000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":18,"alternative-id":["10.1002\/ijgo.71411"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71411","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijgo.71411"}}