IMAJ | volume 27
Journal 5, May 2025
pages: 297-300
1 Meirav High Risk Clinic, Sheba Medical Center, Tel Hashomer, Israel
2 Levy Gertner Oncogenetics Unit, Sheba Medical Center, Tel Hashomer, Israel
3 Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel
4 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Summary
Background:
BRCA1/BRCA2 female pathogenic sequence variant (PSV) carriers in Israel are offered semiannual cancer antigen 125 (CA125) serum level determination and transvaginal ultrasound until performing risk reducing salpingo-oophorectomy (RRSO)
, even with the lack of proven efficacy of these procedures in providing adequate early detection of ovarian cancer.
Objectives:
To report the results of longitudinal CA125 measurements in
BRCA1/BRCA2 carriers as a tool for ovarian cancer detection in a single medical center in Israel.
Methods:
Asymptomatic
BRCA1/BRCA2 PSV carriers attending the Meirav High Risk Clinic at Sheba Medical Center for more than 3 years were eligible. Data on specific PSV, risk reducing surgeries, and cancer diagnoses were obtained from participant records. We used chi-square and Wilcoxon-Rank tests for statistical analyses.
Results:
Overall, 739 (399
BRCA1, 336
BRCA2, 4
BRCA1 + BRCA2) PSV carriers were included. Mean age at the start of follow-up was 38.96 ± 11.13 years, mean follow-up time was
7.93 ± 2.
34 years, (
5860.80 women/years). Most participants (490/739 [66.3%]) had stable CA125 levels (± 5 U/µl). Of participants, 61 had CA125 levels > 35 U/µl at least twice (n=42) or at least doubling of marker levels to a minimum of 20 U/µl (n=19), results that have led to further cancer defining investigations. Of these, 14 and 4 were diagnosed with breast and ovarian cancer, respectively.
Conclusions:
Longitudinally stable CA125 levels were noted in most
BRCA1/BRCA2 PSV carriers and elevated levels were a poor marker for ovarian cancer development.