In the last years, ovarian cancer research has centred particularly on disease prevention, but an increasing number of women are occurring to gynaecology and clinical genetics clinics with family history of ovarian cancer and inherited familial mutations. Over the past 15 years, there has been substantial improvement in the understanding of hereditary ovarian cancer. This interest derived even further in light of the identification of the BRCA1 and BRCA2 genes mutations. The importance of identifying the characteristics of hereditary ovarian cancer (HOC) and to manage the women at risk suitably can greatly improve the care of the population at the highest risk. Women at risk can be recognized by pedigree analysis and may receive counselling from interdisciplinary cancer genetics clinics, while those at high risk need to receive genetic testing. The role of risk calculation programs identifies the risks and helps in decision making for clinical options and genetic testing; they give information on the risks of the disease, its mutation status and the use of genetic testing in the management of high-risk families. Further, while a large number of surrogate preliminary markers have been identified, obviously there are limited and incomplete studies on ovarian cancer genomics. Several options for risk management of HOC are available: surveillance, chemoprevention and prophylactic surgeries. Surveillance in high-risk patients for HOC is lack of safeness. At present, chemoprevention is a controversial issue because of a number of main questions remain to be addressed in developing and testing agents for ovarian cancer chemoprevention. Prophylactic surgery has been shown to really decrease cancer risk and it has the possibility to significantly decrease ovarian cancer mortality.
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