Ovarian cancer is the leading cause of death from gynecologic malignancy and the fifth leading cause of cancer death in American women. A woman in the United States has 1 in 70 risk of developing ovarian cancer in her lifetime. The incidence of ovarian cancer increases in postmenopausal women. Over 70% of ovarian cancers are diagnosed when the cancer has spread beyond the ovary and throughout the abdomen. With the improved therapies with ovarian cancer, the 5-year survival in the United States has shown significant improvement despite the fact that the overall survival has not improved. Despite being labeled a “silent killer,” ovarian cancer does produce symptoms but so often they are only a “whisper.”
Nearly 80% of all ovarian cancers are epithelial in origin. These cancers may be subdivided by cell type to include serious, mucinous, endometrioid, clear cell, and undifferentiated carcinoma. They are further divided by grade 1, 2, 3 and undifferentiated. The tumors of low malignant potential (borderline tumors) are always considered separately because they are less aggressive than invasive carcinoma. The rest of ovarian malignancy include those of germ cell origin, stromal and sex cord tumors.
Genetic factors may result in a hereditary predisposition to ovarian carcinoma. Approximately 10% of ovarian cancers are hereditary. The breast and ovarian genes, BRCA1 and BRCA2, account for most of the predisposition. The lifetime risk of ovarian cancer in women who have the BRCA1 mutation is 45% and the BRCA2 mutation is 25%.
Board Member and Chairman of the Medical Advisory Board
William Baker Professor of Gynecology (Emeritus), Harvard Medical School
Visiting Scholar, Weill Medical College of Cornell University
Former Director of Gynecology, Brigham & Women’s Hospital
Former Director of Gynecology Dana Farber Cancer Center
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