• American College of Obstetricians and Gynecologists (ACOG). Hereditary breast and ovarian cancer syndrome. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 2009 Apr. 10 p. (ACOG practice bulletin; no. 103). [67 references]

This is the current release of the guideline.

The grades of evidence (I-III) and levels of recommendation (A-C) are defined at the end of the "Major Recommendations" field.

The following recommendations are based on good and consistent scientific evidence (Level A):

• Women with BRCA1 or BRCA2 mutations should be offered risk-reducing salpingo-oophorectomy by age 40 years or when childbearing is complete.
• For a risk-reducing bilateral salpingo-oophorectomy, all tissue from the ovaries and fallopian tubes should be removed. Thorough visualization of the peritoneal surfaces with pelvic washings should be performed. Complete, serial sectioning of the ovaries and fallopian tubes is necessary, with microscopic examination for occult cancer.
• A genetic risk assessment is recommended for patients with a greater than an approximate 20–25% chance of having an inherited predisposition to breast cancer and ovarian cancer.

Definitions:

Levels of Evidence

I: Evidence obtained from at least one properly designed randomized controlled trial.

II-1: Evidence obtained from well-designed controlled trials without randomization.

II-2: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

II-3: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments could also be regarded as this type of evidence.

III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

Grades of Recommendations

Level A: Recommendations are based on good and consistent scientific evidence.

Level B: Recommendations are based on limited or inconsistent scientific evidence.

Level C: Recommendations are based primarily on consensus and expert opinion.

None provided

The type of supporting evidence is identified and graded for each recommendation (see "Major Recommendations").

• American College of Obstetricians and Gynecologists (ACOG). Hereditary breast and ovarian cancer syndrome. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 2009 Apr. 10 p. (ACOG practice bulletin; no. 103). [67 references]

Not applicable: The guideline was not adapted from another source.

2009 Apr

American College of Obstetricians and Gynecologists - Medical Specialty Society

American College of Obstetricians and Gynecologists (ACOG)

American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins - Gynecology

ACOG committees are created or abolished and their overall function defined by the Executive Board. Appointments are made for one year, with the understanding that such appointment may be continued for a total of three years. The majority of committee members are Fellows, but Junior Fellows also are eligible for appointment. Some committees may have representatives from other organizations when this is particularly appropriate to committee activities. The president elect appoints committee members annually.

Not stated

This is the current release of the guideline.

Proposed performance measures are included in the original guideline document.

None available

This NGC summary was completed by ECRI Institute on August 19, 2009. The information was verified by the guideline developer on September 11, 2009.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.