Can Salpingo-oophorectomy Reduce the Likelihood of Breast Cancer in High-Risk Women?
Posted: Tuesday, June 8, 2021
Risk-reducing salpingo-oophorectomy (RRSO) may decrease the risk of breast cancer in women with inherited pathogenic variants, according to researchers from the United States, Australia, and Canada. Results from this study indicated that women carrying BRCA1 and BRCA2 pathogenic variants appear to be less likely to develop breast cancer following RRSO, with the greatest risk reduction observed within 5 years after surgery. This case series of nearly 900 families was published in JAMA Oncology.
“Although the primary indication for RRSO is the prevention of ovarian cancer, assessing its association with breast cancer risk is critical to guide clinical decision-making and the timing of such a decision,” stated Laurent Briollais, PhD, of the University of Toronto and Sinai Health System, and colleagues.
Participants included families enrolled in the Breast Cancer Family Registration that carried an inherited variant in BRCA1 (n = 498) or BRCA2 (n = 378). Researchers utilized a survival analysis approach to model the likelihood of developing breast cancer. A time-dependent association of RRSO with breast cancer prognosis before or following 5 years after surgery was compared with 1,000 simulated sets of parameters from the multivariate normal distribution.
Women with BRCA1 and BRCA2 pathogenic variants were found to be less likely to develop primary breast cancer within 5 years of RRSO (hazard ratios = 0.28 and 0.19, respectively). At 5 years after surgery, the risk-reducing properties of RRSO were weaker, with lower hazard ratios for women carrying the BRCA1 and BRCA2 variants. Women with pathogenic variants who underwent RRSO at age 40 exhibited a 49.7% (BRCA1) and 52.7% (BRCA2) cumulative risk of breast cancer by age 70. Women with pathogenic variants who did not undergo RRSO had a greater chance of developing breast cancer by age 70, with a cumulative risk of 61% (BRCA1) and 54% (BRCA2). Further, women carrying BRCA1 pathogenic variants exhibited longer-term risk reduction of breast cancer compared with BRCA2 pathogenic variant carriers.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.