Ovarian cancer is often called a “silent killer” because most people don’t know they have it until it has already spread to other parts of the body. In fact, about 75% of patients are diagnosed at stage 3 or 4, when treatment becomes more difficult. Right now, there is no reliable way to detect ovarian cancer early, and doctors still don’t fully understand how it begins.
But a new study from Mayo Clinic may be changing that. Thanks to the case of a young woman with rare genetic conditions and a dedicated research team, scientists have discovered hidden, early warning signs in the cells of the fallopian tubes—where many ovarian cancers are now believed to begin.
This story started when a 22-year-old woman with two inherited cancer risk conditions came to the Mayo Clinic. She carried mutations in both the BRCA2 gene, which causes hereditary breast and ovarian cancer syndrome (HBOC), and the TP53 gene, which causes Li-Fraumeni syndrome. Both conditions greatly increase the lifetime risk of cancer.
She had already been diagnosed with breast cancer, and imaging also showed a cyst on her ovary. Though the cyst wasn’t cancerous, she decided to take preventive action and had her breasts, uterus, ovaries, and fallopian tubes surgically removed—a step that’s often recommended for people with high inherited cancer risk.
What happened next surprised her doctors and researchers. When they studied the cells from her fallopian tubes under powerful single-cell technology, they saw unusual changes that looked like the earliest stages of ovarian cancer—before any symptoms appeared and before a tumor had even formed.
Dr. Nagarajan Kannan, one of the lead researchers, explained that they were able to trace how the cells in her fallopian tubes had developed in abnormal ways. These changes could be the first warning signs of ovarian cancer. It was a rare chance to catch a glimpse of how cancer may start, especially in someone at such high risk.
Her gynecologic surgeon, Dr. Jamie Bakkum-Gamez, said this discovery may help lead to earlier screening tools and more personalized advice for people with inherited cancer risk. She also noted that the most common and aggressive type of ovarian cancer often starts in the fallopian tubes—but we still don’t know exactly why or how.
To learn more, the Mayo Clinic team created a living fallopian tube biobank. In this project, patients donate cells and tissue from their fallopian tubes, allowing researchers to grow miniature versions of the tubes called organoids. These help scientists study the exact cellular changes that lead to cancer—especially in people with known risk factors like BRCA mutations.
One of the biggest findings in this study was the imbalance of two key cell types in the fallopian tubes. Normally, there are multiciliated cells that help move eggs through the tube, and secretory cells that provide support and fluid.
But in the patient’s tissue, there were far more secretory cells and almost no multiciliated ones. These secretory cells also triggered long-term inflammation, a well-known contributor to cancer.
Using advanced RNA sequencing, the team saw how the development of these cells had gone off track. This may be a sign of how ovarian cancer starts—cell by cell. In another surprising finding, they discovered that the patient’s cells lacked receptors for progesterone, meaning that birth control pills (which can cut ovarian cancer risk by half) might not have worked for her.
Doctoral student Megan Ritting led the genomic analysis in the study and said these kinds of detailed cell studies are helping reshape our understanding of ovarian cancer’s origins.
Thanks to patients who generously donate their tissue and to cutting-edge lab tools, Mayo Clinic researchers are getting closer to understanding the earliest changes that lead to ovarian cancer. This could open new doors to better prevention, earlier detection, and even tailored treatments for people at high risk.
The team’s next step is to use the living biobank to further study exactly when and where ovarian cancer begins in the fallopian tube. Their goal is to catch it in the earliest, most treatable stage—before it can silently grow and spread.
If you care about cancer, please read studies about a new method to treat cancer effectively, and this low-dose, four-drug combo may block cancer spread.
For more health information, please see recent studies about nutrient in fish that can be a poison for cancer, and results showing this daily vitamin is critical to cancer prevention.
The research findings can be found in JCO Precision Oncology.
Copyright © 2025 Knowridge Science Report. All rights reserved.
