Abstract：
OBJECTIVE: Germline mutations in the BRCA gene account for most hereditary ovarian and breast cancer. Management of healthy carriers aims to prevent and allow early detection of breast and ovarian cancer. This study compares six different hereditary ovarian cancer management guidelines, highlighting areas of controversy between different societies. We aim to compare international and national guidelines regarding BRCA carriers\' management.
METHODS: A comparative study. We retrieved, reviewed, and compared the most recent guidelines of BRCA mutation carriers from the specializing societies NCCN (National Comprehensive National network) and ESMO (European society of medical oncology), and national societies of the United States (American College of Obstetricians and Gynecologists), England (the Royal College of Obstetricians and Gynecologists), Canada (the Society of Obstetricians and Gynaecologists of Canada) and Spain (Sociedad Española de Oncología Médica).
RESULTS: There is a broad consensus regarding the limited role of screening for early ovarian cancer detection (4 out of 6) (4/6) and regarding the recommendation for implementation of Risk-reducing salpingo-oophorectomy (RRSO) (6/6), some variations exist for age at RRSO. It is widely accepted that risk reducing salpingectomy should be performed only as part of research (5/6), and that the addition of risk-reducing hysterectomy should be individualized (3/6). Not all guidelines address fertility issues, and controversy exists regarding hormone replacement therapy (HRT) recommendations in unaffected young BRCA-mutation carriers following RRSO.
CONCLUSIONS: BRCA carrier\'s management guidelines consist of well-agreed topics such as the ineffective screening for early detection of ovarian cancer and the recommendation of RRSO. HRT remains controversial. Conforming unified recommendations is needed for providing evidence-based recommendations.
METHODS: A comparative study. We retrieved, reviewed, and compared the most recent guidelines of BRCA mutation carriers from the specializing societies NCCN (National Comprehensive National network) and ESMO (European society of medical oncology), and national societies of the United States (American College of Obstetricians and Gynecologists), England (the Royal College of Obstetricians and Gynecologists), Canada (the Society of Obstetricians and Gynaecologists of Canada) and Spain (Sociedad Española de Oncología Médica).
RESULTS: There is a broad consensus regarding the limited role of screening for early ovarian cancer detection (4 out of 6) (4/6) and regarding the recommendation for implementation of Risk-reducing salpingo-oophorectomy (RRSO) (6/6), some variations exist for age at RRSO. It is widely accepted that risk reducing salpingectomy should be performed only as part of research (5/6), and that the addition of risk-reducing hysterectomy should be individualized (3/6). Not all guidelines address fertility issues, and controversy exists regarding hormone replacement therapy (HRT) recommendations in unaffected young BRCA-mutation carriers following RRSO.
CONCLUSIONS: BRCA carrier\'s management guidelines consist of well-agreed topics such as the ineffective screening for early detection of ovarian cancer and the recommendation of RRSO. HRT remains controversial. Conforming unified recommendations is needed for providing evidence-based recommendations.
摘要：
目的：BRCA基因中的种系突变占大多数遗传性卵巢癌和乳腺癌。健康携带者的管理旨在预防和允许早期发现乳腺癌和卵巢癌。这项研究比较了六种不同的遗传性卵巢癌治疗指南，突出不同社会之间的争议领域。我们的目标是比较有关BRCA运营商管理的国际和国家指南。
方法：比较研究。我们找到了，reviewed,并比较了来自NCCN（国家综合国家网络）和ESMO（欧洲医学肿瘤学会）的BRCA突变携带者的最新指南，和美国国家协会（美国妇产科学院），英格兰（皇家妇产科学院），加拿大（加拿大妇产科医师协会）和西班牙（西班牙医院）。
结果：关于筛查早期卵巢癌检测的作用有限（6个中的4个）（4/6）和关于实施降低风险的输卵管卵巢切除术（RRSO）（6/6）的建议，已达成广泛共识。RRSO的年龄存在一些差异。人们普遍认为，减少输卵管切除术的风险应仅作为研究的一部分进行（5/6），并且增加降低风险的子宫切除术应个体化（3/6）。并非所有指南都涉及生育问题，对于RRSO术后未受影响的年轻BRCA突变携带者的激素替代疗法(HRT)建议存在争议.
结论：BRCA携带者的管理指南包括公认的主题，例如卵巢癌早期检测的无效筛查和RRSO的建议。HRT仍然存在争议。为了提供基于证据的建议，需要遵循统一的建议。
方法：比较研究。我们找到了，reviewed,并比较了来自NCCN（国家综合国家网络）和ESMO（欧洲医学肿瘤学会）的BRCA突变携带者的最新指南，和美国国家协会（美国妇产科学院），英格兰（皇家妇产科学院），加拿大（加拿大妇产科医师协会）和西班牙（西班牙医院）。
结果：关于筛查早期卵巢癌检测的作用有限（6个中的4个）（4/6）和关于实施降低风险的输卵管卵巢切除术（RRSO）（6/6）的建议，已达成广泛共识。RRSO的年龄存在一些差异。人们普遍认为，减少输卵管切除术的风险应仅作为研究的一部分进行（5/6），并且增加降低风险的子宫切除术应个体化（3/6）。并非所有指南都涉及生育问题，对于RRSO术后未受影响的年轻BRCA突变携带者的激素替代疗法(HRT)建议存在争议.
结论：BRCA携带者的管理指南包括公认的主题，例如卵巢癌早期检测的无效筛查和RRSO的建议。HRT仍然存在争议。为了提供基于证据的建议，需要遵循统一的建议。
