When analyzing all patients regardless of their hormonal status, mean serum HE4 levels in BRCA1 carriers were significantly lower than in the remaining groups (uterine myomas P = 0.0138; noncancer ovarian cysts P = 0.0001; adnexitis P = 0.0079; endometrial cancer P = 0.0000; other gynecological cancers P = 0.0000; endometrial polyps P = 0.0023; metastatic tumors P = 0.000579; ovarian cancers P = 0.0000), with the exception of benign epithelial ovarian tumors (P = 0.1834). This evidence concerns the gene BRCA1 and metastatic neoplasm.