Biogenomic pathways in breast and ovarian malignancies: Clinical and surgical workflow focused on tailoring procedures

A. Tinelli, A. Malvasi, V. Lorusso, V. E. Chiuri, S. Cinieri, D. Vergara, R. Martignago, U. Vergari, M. Pisano, G. Leo

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Breast and ovarian cancers are the most common worldwide gynaecological cancers and connected to germline mutations in the tumour suppressor genes BRCA1 and BRCA2, both involved in different cellular mechanism, such as DNA damage recognition, double-strand break repair, checkpoint control, transcription regulation and chromatin remodelling. The inactivation of BRCA-related pathways is probably associated with significantly higher percentages of these gynaecological cancers. In this elaborate are discussed the biogenomic perspectives in gynecological surgery and the current opportunity to treat breast and ovarian malignancies by tailoring minimally invasive procedures, basing on molecular genetic analysis and by using of prophylactic surgery. The authors reviewed the clinical and genetic evaluation for germline mutations to monitor the women predisposed to cancer developments and to choose the risk reduction strategies, based on a more precise estimate of individual risk; in the high risk women, the authors focused on the tailoring minimally invasive gynaecological procedures, a preemptive prophylactic surgery based on molecular genetic analysis, targeting to an organ or a part of its prior to malignant transformation or while the cancer is in situ. Clinical and surgical workflow in high risk patients for breast and ovarian cancers include highly sensitive screening, starting at a young age, and the use of tailoring minimally invasive operations on the ovaries or on the breast; the tailoring surgery, based on molecular genetic analysis and targeting a low tumor burden, have the potential to achieve greater cure rates than extensive resections required for clinically evident disease and, moreover, it is as an acceptable surgical approach for smaller incisions, less postoperative pain, and shorter hospital stays.

Original languageEnglish
Title of host publicationDNA: Fingerprinting, Sequencing and Chips
PublisherNova Science Publishers, Inc.
Pages119-132
Number of pages14
ISBN (Print)9781607418146
Publication statusPublished - 2009

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Keywords

  • BRCA 1 mutation
  • BRCA 2 mutation
  • Breast cancers
  • Gynecological tumors
  • Minimally invasive surgery
  • Ovarian cancers
  • Prophylactic surgery.

ASJC Scopus subject areas

  • Social Sciences(all)

Cite this

Tinelli, A., Malvasi, A., Lorusso, V., Chiuri, V. E., Cinieri, S., Vergara, D., Martignago, R., Vergari, U., Pisano, M., & Leo, G. (2009). Biogenomic pathways in breast and ovarian malignancies: Clinical and surgical workflow focused on tailoring procedures. In DNA: Fingerprinting, Sequencing and Chips (pp. 119-132). Nova Science Publishers, Inc..