Ovarian cancer - early detection via the fallopian tube?

New research recently reported at the American Association of Cancer Research suggests that fallopian tube cells rather than ovarian surface cells are the probable site of origin of most cases of ovarian serous carcinoma, the most common type of ovarian cancer. This finding may lead to earlier detection, as well as better treatment and perhaps even prevention of ovarian cancer.

There is no reliable early diagnostic test for ovarian cancer, so approximately 80 percent of cases are diagnosed at a very late stage. Thus when oncologists diagnose ovarian cancer, they often find massive invasive tumours on the surface of the ovary (usually the tumor does not invade the ovary). It is rare to find early pre-invasive in situ tumours, as with breast cancer.

Levanon and colleagues studied a group of women at very high risk for ovarian cancer due to family history who underwent removal of their fallopian tubes and ovaries as a preventive measure. When these women were closely evaluated, it was found that they had early cancerous growths, and these early growths were in the fallopian tube, not on the surface of the ovary. The growths were confined to a particular area within the fallopian tube called the fimbria, which is located close to the ovary.

The team's findings may change how pathologists examine fallopian tubes after surgical removal, with a new emphasis on the fimbria to measure the incidence of precursors and early cancers among women who carry BRCA mutations. Future studies may explore connections between specific genetic or environmental modifiers and the incidence of precursor lesions in the fimbria.