Risk-reducing Surgery Beneficial for Women with BRCA Mutations
Reductions in cancer risk, mortality seen
Risk-reducing surgery reduced the risk for breast and ovarian cancer in a study of women with BRCA1 or BRCA2 mutations. Prophylactic salpingo-oophorectomy also reduced all-cause and cancer-specific mortality in these high-risk women.
The prospective, multicenter study by Timothy R. Rebbeck, PhD, of the University of Pennsylvania Medical School, Philadelphia, and associates included 2482 women with BRCA1 or BRCA2 mutations (JAMA. 2010;304:967-975). Only 10% of these women chose risk-reducing mastectomy (RRM) and 38% underwent risk-reducing salpingo-oophorectomy (RRSO).
None of the 247 women who underwent RRM were diagnosed with breast cancer during the 3-year follow-up period compared with 7% of those who did not have RRM. RRSO reduced the risk of ovarian cancer by 86% (6% vs 1% in women with a prior diagnosis of breast cancer; 6% vs 2% in those without a prior diagnosis of breast cancer). Risk of first breast cancers was reduced by 37% in women with BRCA1 mutations and by 64% in those with BRCA2 mutations.
Compared with women who did not have RRSO, those who did also had lower all-cause mortality (10% vs 3%), breast cancer–specific mortality (6% vs 2%), and ovarian cancer mortality (3% vs 0.4%).
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