SABCS 2024: Risk-Reducing Surgery in BRCA Carriers With Early-Onset Breast Cancer?

By: Julia Cipriano, MS
Posted: Friday, December 20, 2024

Young BRCA carriers with breast cancer may benefit from risk-reducing surgery, based on the international, multicenter, hospital-based, retrospective BRCA BCY Collaboration cohort study conducted by Matteo Lambertini, MD, PhD, of the University of Genoa, Italy, and colleagues. They presented their findings during the 2024 San Antonio Breast Cancer Symposium (SABCS; Abstract GS1-08).

“We believe our findings are critical for improving the counseling of [these patients] on cancer risk-management strategies,” commented Dr. Lambertini in an American Association for Cancer Research press release.

The investigators focused on 5,290 germline BRCA carriers (BRCA1: 63.5%) who were diagnosed with stage I to III invasive breast cancer at age 40 or younger (median age = 35 years). Of this population, 55.0% and 52.6% underwent bilateral risk-reducing mastectomy and risk-reducing salpingo-oophorectomy, respectively.

At a median follow-up of 8.2 years, 686 (13.0%) overall survival, 1,923 (36.3%) disease-free survival, and 1,751 (33.1%) breast cancer–free interval events were reported. Patients who underwent mastectomy had a significantly reduced risk of experiencing overall survival events (adjusted hazard ratio [aHR] = 0.65). According to the investigators, this association was observed irrespective of the BRCA mutation, age at diagnosis, tumor subtype, tumor size, and nodal status. The risks of disease-free survival (aHR = 0.58) and breast cancer–free interval (aHR = 0.55) events were also found to be significantly reduced after mastectomy.

Salpingo-oophorectomy was associated with a significantly reduced risk of overall survival events (aHR = 0.58), irrespective of age at diagnosis, tumor size, and nodal status, according to the investigators. Significant interactions were identified based on BRCA mutation (BRCA1: aHR = 0.44; BRCA2: aHR = 0.85) and tumor subtype (triple-negative: aHR = 0.44; hormone receptor–positive: aHR = 0.80). Patients who underwent salpingo-oophorectomy also had significantly reduced risks of experiencing disease-free survival (aHR = 0.68) and breast cancer–free interval (aHR = 0.65) events.

Disclosure: For full disclosures of the study authors, visit sabcs.org.

2024 San Antonio Breast Cancer Symposium

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