Altered surface and cyst epithelium of ovaries removed prophylactically from women with a family history of ovarian cancer

Bruce A. Werness, Alaa M Afify, Kenneth L. Bielat, Gamal H. Eltabbakh, M. Steven Piver, Joyce M. Paterson

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


Despite intensive investigation, the nature of epithelial ovarian cancer precursors remains controversial. Because women with a strong family history of ovarian cancer have a high probability of developing ovarian cancer themselves, ovaries removed prophylactically from such patients provide an opportunity to identify early neoplastic changes. Ovaries removed from 64 consecutive patients undergoing prophylactic oophorectomy and from 30 women with normal ovaries and no known family history of ovarian cancer were examined by light microscopy for a number of histopathologic features and by image cytometry for abnormalities of the cyst and surface epithelium. All analyses were performed without knowledge of the family history. Seven benign, but no tumors of low malignant potential or malignant epithelial tumors were found in the prophylactic oophorectomy group. There were more cortical inclusion cysts in the prophylactically removed than controls ovaries (P = .016), but no other architectural features differed between the two groups. No abnormalities were found in the surface or cyst epithelium in either group by light microscopy. In contrast, image analysis identified differences in the nuclei between the two groups, indicating that those from the surface epithelium of prophylactically removed ovaries were larger and contained more heterogeneously dense chromatin than those of controls, and that nuclei of the cyst epithelium had more irregular outlines. Ovarian epithelium from prophylactically removed ovaries exhibit abnormalities that are only identified by image analysis, and which might represent early preneoplastic changes. Such ovaries may be useful for identifying early molecular changes in ovarian cancer.

Original languageEnglish (US)
Pages (from-to)151-157
Number of pages7
JournalHuman Pathology
Issue number2
StatePublished - 1999
Externally publishedYes


  • Familial ovarian cancer
  • Image cytometry
  • Ovarian neoplasms
  • Precancerous conditions
  • Prophylactic oophorectomy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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