Noah Kauff

Positions:

Instructor, Temporary in the Obstetrics and Gynecology

Obstetrics and Gynecology, Gynecologic Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1993

University of Pennsylvania

Grants:

Publications:

Treatment of infertility does not increase the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation.

OBJECTIVE: To evaluate the relationship between use of fertility medication (i.e., selective estrogen receptor [ER] modulator, gonadotropin, or other) or infertility treatment (i.e., IVF or IUI) and the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation. DESIGN: A matched case-control study of 941 pairs of BRCA1 or BRCA2 mutation carriers with and without a diagnosis of ovarian cancer. SETTING: Genetic clinics. PATIENT(S): Detailed information regarding treatment of infertility was collected from a routinely administered questionnaire. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals associated with fertility treatment. RESULT(S): There was no significant relationship between the use of any fertility medication or IVF treatment (odds ratio, 0.66; 95% confidence interval 0.18-2.33) and the subsequent risk of ovarian cancer. CONCLUSION(S): Our findings suggest that treatment for infertility does not significantly increase the risk of ovarian cancer among women with a BRCA mutation.
Authors
Gronwald, J; Glass, K; Rosen, B; Karlan, B; Tung, N; Neuhausen, SL; Moller, P; Ainsworth, P; Sun, P; Narod, SA; Lubinski, J; Kotsopoulos, J; Hereditary Breast Cancer Clinical Study Group,
MLA Citation
Gronwald, Jacek, et al. “Treatment of infertility does not increase the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation..” Fertil Steril, vol. 105, no. 3, Mar. 2016, pp. 781–85. Pubmed, doi:10.1016/j.fertnstert.2015.11.034.
URI
https://scholars.duke.edu/individual/pub1327343
PMID
26698676
Source
pubmed
Published In
Fertility and Sterility
Volume
105
Published Date
Start Page
781
End Page
785
DOI
10.1016/j.fertnstert.2015.11.034

Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC).

OBJECTIVE: Risk-reducing salpingo-oophorectomy (RRSO) is recommended for women with BRCA mutation due to increased risk of pelvic serous carcinoma. Serous tubal intraepithelial carcinoma (STIC) is a pathologic finding of unknown clinical significance. This study evaluates the clinical outcome of patients with isolated STIC. MATERIALS/METHODS: We retrospectively reviewed the medical records of consecutive patients with a germline BRCA1/2 mutation or a high-risk personal or family history of ovarian cancer who underwent RRSO between January 2006 and June 2011. All patients had peritoneal washings collected. All surgical specimens were assessed using the sectioning and extensively examining the fimbria protocol, with immunohistochemistry when indicated. p53 signature lesions and secretory cell outgrowths were excluded. RESULTS: Of 593 patients who underwent RRSO, isolated STIC was diagnosed in 12 patients (2%). Five patients (42%) were BRCA1 positive, 5 patients (42%) were BRCA2 positive, and 2 patients (17%) had high-risk family history. Preoperatively, all patients with STIC had normal CA-125 levels and/or pelvic imaging results. Seven patients underwent hysterectomy and omentectomy, 6 patients (46%) had pelvic node dissections, and 5 patients (39%) had para-aortic node dissections. With the exception of positive peritoneal washings in 1 patient, no invasive or metastatic disease was identified. No patient received adjuvant chemotherapy. At median follow-up of 28 months (range, 16-44 months), no recurrences have been identified. CONCLUSIONS: Among the cases of isolated STIC after RRSO reported in the literature, the yield of surgical staging is low, and short-term clinical outcomes are favorable. Peritoneal washings are the most common site of disease spread. Individualized management is warranted until additional data become available.
Authors
Wethington, SL; Park, KJ; Soslow, RA; Kauff, ND; Brown, CL; Dao, F; Otegbeye, E; Sonoda, Y; Abu-Rustum, NR; Barakat, RR; Levine, DA; Gardner, GJ
MLA Citation
Wethington, Stephanie L., et al. “Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC)..” Int J Gynecol Cancer, vol. 23, no. 9, Nov. 2013, pp. 1603–11. Pubmed, doi:10.1097/IGC.0b013e3182a80ac8.
URI
https://scholars.duke.edu/individual/pub1327357
PMID
24172097
Source
pubmed
Published In
Int J Gynecol Cancer
Volume
23
Published Date
Start Page
1603
End Page
1611
DOI
10.1097/IGC.0b013e3182a80ac8

Assessment of the prevalence of de novo mutations in the BRCA1 and BRCA2 genes.

Authors
Zhang, L; Fleischut, MH; Kohut, K; Spencer, S; Wong, K; Stadler, ZK; Kauff, ND; Offit, K; Robson, ME
MLA Citation
Zhang, L., et al. “Assessment of the prevalence of de novo mutations in the BRCA1 and BRCA2 genes..” Clin Genet, vol. 80, no. 1, July 2011, pp. 97–98. Pubmed, doi:10.1111/j.1399-0004.2011.01691.x.
URI
https://scholars.duke.edu/individual/pub1327389
PMID
21649643
Source
pubmed
Published In
Clin Genet
Volume
80
Published Date
Start Page
97
End Page
98
DOI
10.1111/j.1399-0004.2011.01691.x

Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers.

BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) is widely used by carriers of BRCA1 or BRCA2 (BRCA1/2) mutations to reduce their risks of breast and ovarian cancer. To guide women and their clinicians in optimizing cancer prevention strategies, we summarized the magnitude of the risk reductions in women with BRCA1/2 mutations who have undergone RRSO compared with those who have not. METHODS: All reports of RRSO and breast and/or ovarian or fallopian tube cancer in BRCA1/2 mutation carriers published between 1999 and 2007 were obtained from a PubMed search. Hazard ratio (HR) estimates were identified directly from the original articles. Pooled results were computed from nonoverlapping studies by fixed-effects meta-analysis. RESULTS: Ten studies investigated breast or gynecologic cancer outcomes in BRCA1/2 mutation carriers who had undergone RRSO. Breast cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers, four of BRCA1 mutation carriers, and three of BRCA2 mutation carriers. Gynecologic cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers and one of BRCA1 mutation carriers. RRSO was associated with a statistically significant reduction in risk of breast cancer in BRCA1/2 mutation carriers (HR = 0.49; 95% confidence interval [CI] = 0.37 to 0.65). Similar risk reductions were observed in BRCA1 mutation carriers (HR = 0.47; 95% CI = 0.35 to 0.64) and in BRCA2 mutation carriers (HR = 0.47; 95% CI = 0.26 to 0.84). RRSO was also associated with a statistically significant reduction in the risk of BRCA1/2-associated ovarian or fallopian tube cancer (HR = 0.21; 95% CI = 0.12 to 0.39). Data were insufficient to obtain separate estimates for ovarian or fallopian tube cancer risk reduction with RRSO in BRCA1 or BRCA2 mutation carriers. CONCLUSION: The summary estimates presented here indicate that RRSO is strongly associated with reductions in the risk of breast, ovarian, and fallopian tube cancers and should provide guidance to women in planning cancer risk reduction strategies.
Authors
Rebbeck, TR; Kauff, ND; Domchek, SM
MLA Citation
Rebbeck, Timothy R., et al. “Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers..” J Natl Cancer Inst, vol. 101, no. 2, Jan. 2009, pp. 80–87. Pubmed, doi:10.1093/jnci/djn442.
URI
https://scholars.duke.edu/individual/pub1327412
PMID
19141781
Source
pubmed
Published In
J Natl Cancer Inst
Volume
101
Published Date
Start Page
80
End Page
87
DOI
10.1093/jnci/djn442

Reducing the risk of gynecologic cancer in the Lynch syndrome.

Authors
Offit, K; Kauff, ND
MLA Citation
Offit, Kenneth, and Noah D. Kauff. “Reducing the risk of gynecologic cancer in the Lynch syndrome..” N Engl J Med, vol. 354, no. 3, Jan. 2006, pp. 293–95. Pubmed, doi:10.1056/NEJMe058284.
URI
https://scholars.duke.edu/individual/pub1327396
PMID
16421372
Source
pubmed
Published In
The New England Journal of Medicine
Volume
354
Published Date
Start Page
293
End Page
295
DOI
10.1056/NEJMe058284