[...]... across both strands are thought to be repaired: nonhomologous end-joining, direct conversion, and single-strand annealing BRCA1 and BRCA2 have been demonstrated to co-localize with RAD51, itself critical for DNA repair, at sites of DNA damage [3] BRCA1 currently is thought to function upstream of both the direct conversion and the single-strand annealing pathways and may influence selection of a repair... The roles of BRCA1 and BRCA2 and associated proteins in the maintenance of genomic stability Oncogene 2006;25(43):5864–74 [4] King M-C, Marks JH, Mandell JB, for The New York Breast Cancer Study Group Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2 Science 2003; 302:643–6 [5] Risch HA, McLaughlin JR, Cole DEC, et al Prevalence and penetrance of germline BRCA1 and BRCA2... supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis Lancet 2004;364(9441): 1219–28 [4] Cho E, Hunter DJ, Spiegelman D, et al Intakes of vitamins A, C and E and folate and multivitamins and lung cancer: a pooled analysis of 8 prospective studies Int J Cancer 2006; 118(4):970–8 [5] Davies AA, Davey Smith G, Harbord R, et al Nutritional interventions and outcome in patients... imperative for the patient to understand the risks, benefits, and limitations of each strategy Intensified screening In large, unselected groups of patients, screening for ovarian cancer by serum CA-125 levels and/ or transvaginal sonography has proven to be of little to no benefit This lack of benefit results, in large part, from the poor sensitivity and specificity of these tests In patients who have a... attributable to OCP use In what is by far the largest study of its kind to date, McLaughlin and colleagues [22] support the conclusions of Narod and colleagues [20] In an epidemiologic survey of more than 3000 BRCA mutation carriers, the risk of ovarian cancer was reduced for BRCA1 and BRCA2 carriers, with odds ratios for developing ovarian cancer of 0.56 and 0.39, respectively, for women who had used OCPs... hormone replacement therapy following prophylactic BSO is a safe treatment alternative for many patients and could substantially improve quality of life The method of prophylactic BSO and the pathologic handling and examination of the removed tissues are of critical importance to the proper management of the BRCA carrier (Box 1) The adnexae are relatively easy to remove completely Attention should be paid... MSH2, and MSH6, among others) are critical entities in the normal function of the cell In the absence of intact DNA mismatch repair, DNA strands develop microsatellite instability, leading to rapid accumulation of mutations in critical genes of proliferation and cell-cycle control The diagnosis of HNPCC can be made by family history, as defined by the revised Amsterdam criteria A full description of the... see front matter Ó 2007 Elsevier Inc All rights reserved doi:10.1016/j.ogc .2007. 09.005 obgyn.theclinics.com 652 PAVELKA et al each of these genes in their mutant forms (that is, increased risk of breast and ovarian cancer) probably reflects their functional similarity First identified in the mid-1990s, BRCA1 and BRCA2 are the tumor suppressor genes involved in the repair of double-strand DNA breaks, among... oncology, genetic/ familial high risk assessment: breast and ovarian V.I 2007 Available at: www.nccn.org Accessed September 1, 2007 [19] Goff BA, Mandel LS, Melancon CH, et al Frequency of symptoms of ovarian cancer in women presenting to primary care clinics JAMA 2004;291(22):2705–12 [20] Narod SA, Risch H, Moslehi R, et al Oral contraceptives and the risk of hereditary ovarian cancer Hereditary Ovarian Cancer... rights reserved doi:10.1016/j.ogc .2007. 10.001 obgyn.theclinics.com 668 DANN et al developing ovarian cancer over their lifetime Mutations in the breast and ovarian cancer-susceptibility genes BRCA1 and BRCA2 confer an increased lifetime risk of ovarian cancer These mutations also increase the risk of breast and pancreatic cancer in both male and female carriers; the risk of prostate cancer is increased . screening. The purpose of this issue of the Obstetrics and Gynecologic Clinics of North America is to review the basics of cancer prevention and screening that will help. care. William F. Rayburn, MD Department of Obstetrics and Gynecology University of New Mexico School of Medicine MSC10 5580 1 University of New Mexico Albuquerque,