Dr. Javier de la Torre, researcher of the Biomedical Research in Gynecology group at Vall d'Hebron Research Institute (VHIR), has been one of the speakers in the 'Best Paper International Journal of Gynecology and Obstetrics' session at the World Congress on Gynecology and Obstetrics (FIGO2018), held in Rio de Janeiro and attended by 11,500 specialists from around the world. Vall d'Hebron has been the only European center participating in this session.Initially, the work, carried out at the Oncologic Gynecology Unit and at the Breast Pathology Unit of Vall d'Hebron and VHIR, was presented as an oral communication but the organization selected it from among the five best communications at the international level to be presented at a session.Patients carrying the BRCA1/2 mutation have a higher risk of developing an ovarian carcinoma. Consequently, between the ages of 35 and 40, it is recommended that they undergo prophylactic surgery for the removal of fallopian tubes and ovaries. The study of Dr. Javier de la Torre, researcher of the Biomedical Research in Gynecology group at Vall d'Hebron Research Institute (VHIR), proposed to identify precursor lesions of ovarian cancer in patients with BRCA1 and BRCA2 mutations.Researchers analyzed the presence of pre-invasive lesions and associated clinical predictors in 152 females that were mutation BRCA1/2 carriers and subjected to RRSO (risk-reducing salpingo-oophorectomy) at Vall d'Hebron Hospital for a period of nine years. Clinical-pathological data were obtained: age at the time of RRSO, parity, personal history of breast cancer, levels of CA125, ultrasound results, mutation type and final histology. All the tubes/ovaries were evaluated at the Pathological Anatomy Service (Dr. García) using the SEE-FIM protocol with IHQ for p53 and Ki67.The anatomopathological and immunohistochemical study confirmed p53 signature lesions and STIC (Intraepithelial tubal serous carcinoma) to 14 women (9.2%) and 2 patients were diagnosed with invasive carcinoma, which supports tubal origin in ovarian carcinogenesis. Multivariate analyses showed a positive correlation between the age over 45 with the presence of invasive and pre-invasive lesions. Therefore, around 9% of carriers of BRCA1/2 mutation will have a pre-invasive injury during the RRSO and, in the case of women over 45, this risk is significantly increased. This suggests that the identification of new predictive markers in the development of precursor lesions can help us in the future to differentiate the risk-reducing salpingo-oophorectomy when possible. Thus, efforts and future research should move towards this direction. The VHIR research to identify precursor lesions of ovarian cancer in patients carrying BRCA1/2 mutationsOvarian cancer is the leading cause of death due to gynecological malignancy in women owing to the diagnosis in advanced stages in more than 75% of cases. Patients with mutations in the genes BRCA1 and BRCA2 have a greater risk of suffering it (40% and 20%, respectively). This risk progressively increases with age, being greater after the age of 50-60.Due to the lack of early detection strategies, BRCA mutation patients are recommended to carry out prophylactic surgery with the extraction of both tubes and ovaries from the age of 35-40. However, the development of early menopause has been associated with higher morbidity and mortality in the long term. The aim is to study and characterize by means of immunohistochemical and proteomic techniques molecular profiles associated with the development of tubal precursor lesions and ovarian cancer in patients with BRCA1/2 mutation, with the subsequent goal of identifying biomarkers that allow stratification of patients with more or less risk of developing this cancer. This could delay prophylactic surgery in order to avoid the adverse effects associated with an early menopause, and thus improve the survival and quality of life of these women.From 2012, Dr. Javier de la Torre is part of the Oncologic Gynecology team and Breast Pathology Unit at the Vall d'Hebron Hospital, led by Dr. Ma Asunción Pérez Benavente, Dr. Martín Espinosa and Dr. Antonio Gil-Moreno as Head of the Gynecology and Obstetrics Service. He is responsible for the monographic consultation on pre and post-surgical gynecological follow-up in patients carrying mutations in BRCA genes. He is also a researcher at the VHIR's Biomedical Research in Gynecology group and specifically in the research line on ovarian cancer coordinated by Dr. Anna Santamaría.