More extensive examination of the fallopian tubes and increased uptake of risk reducing procedures (BRCA1, BRCA2 mutation carriers) or opportunistic salpingectomies (general population) have resulted in the increased detection of serous tubal intraepithelial carcinoma (STIC) in the fallopian tubes, the putative precursor lesion to high-grade serous carcinomas of the ovary.
When performing a risk reducing bilateral BSO for women with a BRCA1 or BRCA2 mutation, a STIC will be found in approximately 3.5-5.5% of patients34, 35, 36. In women having an opportunistic salpingectomy for benign disease or in women with a high risk family history, STIC may be found in approximately 0.6-1.1% of patients.
When an isolated STIC is identified a referral should be made to BC Cancer for consideration of completion surgical staging (minimum washings, omentectomy, directed biopsies, +/- hysterectomy). Approximately 4.5% of high-risk women (with BRCA1 or BRCA2 mutations) with a STIC will later develop of primary peritoneal carcinoma, and the median time to the development 4-6 years. Only women with invasive disease found at the time of completion surgery should be offered post-operative chemotherapy.
When an isolated STIC is identified in ‘low-risk’/general population of women, a referral should be made to both BC Cancer for consideration of completion surgical staging as well as to the Hereditary Cancer Program.
These women have a 10% chance of carrying a germline BRCA1 or BRCA2 mutation, which, if discovered would encourage consideration of surgical staging34