BRCA1-associated ovarian carcinoma compared to sporadic high-grade serous ovarian carcinoma is characterized by:

• A Earlier FIGO stage at diagnosis and worse prognosis
• B Higher risk of mucinous histological subtype
• C Better response to platinum-based chemotherapy and improved survival ✓
• D Association with Lynch syndrome and microsatellite instability

Explanation

BRCA1/2 mutations impair homologous recombination DNA repair, making tumors highly sensitive to platinum compounds and PARP inhibitors (olaparib, niraparib). Despite similar or later stage at diagnosis, BRCA-mutated high-grade serous carcinomas have significantly better progression-free and overall survival. They are predominantly serous, not mucinous histotype. Lynch syndrome (MLH1, MSH2 mutations) is associated with endometrial and colorectal, not primarily ovarian, carcinoma.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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