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Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk: an international prospective cohort of BRCA1 and BRCA2 mutation carriers
GENEPSO, EMBRACE, HEBON, kConFab Investigators, IBCCS, kConFab, BCFR, Mavaddat, N., Antoniou, A. C., Mooij, T. M., Hooning, M. J., Heemskerk-Gerritsen, B. A., Nogues, C. & Gauthier-Villars, M., 16-Jan-2020, In : Breast cancer research. 22, 1, 11 p., 8.Research output: Contribution to journal › Article › Academic › peer-review
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Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk : an international prospective cohort of BRCA1 and BRCA2 mutation carriers. / GENEPSO; EMBRACE; HEBON; kConFab Investigators; IBCCS; kConFab; BCFR; Mavaddat, Nasim; Antoniou, Antonis C.; Mooij, Thea M.; Hooning, Maartje J.; Heemskerk-Gerritsen, Bernadette A.; Nogues, Catherine; Gauthier-Villars, Marion.
In: Breast cancer research, Vol. 22, No. 1, 8, 16.01.2020.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk
T2 - an international prospective cohort of BRCA1 and BRCA2 mutation carriers
AU - GENEPSO
AU - EMBRACE
AU - HEBON
AU - kConFab Investigators
AU - IBCCS
AU - kConFab
AU - BCFR
AU - Mavaddat, Nasim
AU - Antoniou, Antonis C.
AU - Mooij, Thea M.
AU - Hooning, Maartje J.
AU - Heemskerk-Gerritsen, Bernadette A.
AU - Nogues, Catherine
AU - Gauthier-Villars, Marion
AU - Laborde, Lilian
AU - Breysse, Emmanuel
AU - Stoppa-Lyonnet, Dominique
AU - Buecher, Bruno
AU - Caron, Olivier
AU - Fourme-Mouret, Emmanuelle
AU - Fricker, Jean-Pierre
AU - Lasset, Christine
AU - Bonadona, Valerie
AU - Berthet, Pascaline
AU - Faivre, Laurence
AU - Luporsi, Elisabeth
AU - Mari, Veronique
AU - Gladieff, Laurence
AU - Gesta, Paul
AU - Sobol, Hagay
AU - Eisinger, Francois
AU - Nogues, Catherine
AU - Longy, Michel
AU - Dugast, Catherine
AU - Colas, Chrystelle
AU - Coupier, Isabelle
AU - Pujol, Pascal
AU - Corsini, Carole
AU - Lortholary, Alain
AU - Vennin, Philippe
AU - Adenis, Claude
AU - Nguyen, Tan Dat
AU - Delnatte, Capucine
AU - Tinat, Julie
AU - Tennevet, Isabelle
AU - Limacher, Jean-Marc
AU - Maugard, Christine
AU - Bignon, Yves-Jean
AU - Demange, Liliane
AU - Penet, Clotilde
AU - Dreyfus, Helene
AU - Cohen-Haguenauer, Odile
AU - Venat-Bouvet, Laurence
AU - Mensenkamp, A. R.
AU - Blok, M. J.
AU - Oosterwijk, J. C.
AU - Mourits, Marian J. E.
PY - 2020/1/16
Y1 - 2020/1/16
N2 - Background The effect of risk-reducing salpingo-oophorectomy (RRSO) on breast cancer risk for BRCA1 and BRCA2 mutation carriers is uncertain. Retrospective analyses have suggested a protective effect but may be substantially biased. Prospective studies have had limited power, particularly for BRCA2 mutation carriers. Further, previous studies have not considered the effect of RRSO in the context of natural menopause. Methods A multi-centre prospective cohort of 2272 BRCA1 and 1605 BRCA2 mutation carriers was followed for a mean of 5.4 and 4.9 years, respectively; 426 women developed incident breast cancer. RRSO was modelled as a time-dependent covariate in Cox regression, and its effect assessed in premenopausal and postmenopausal women. Results There was no association between RRSO and breast cancer for BRCA1 (HR = 1.23; 95% CI 0.94-1.61) or BRCA2 (HR = 0.88; 95% CI 0.62-1.24) mutation carriers. For BRCA2 mutation carriers, HRs were 0.68 (95% CI 0.40-1.15) and 1.07 (95% CI 0.69-1.64) for RRSO carried out before or after age 45 years, respectively. The HR for BRCA2 mutation carriers decreased with increasing time since RRSO (HR = 0.51; 95% CI 0.26-0.99 for 5 years or longer after RRSO). Estimates for premenopausal women were similar. Conclusion We found no evidence that RRSO reduces breast cancer risk for BRCA1 mutation carriers. A potentially beneficial effect for BRCA2 mutation carriers was observed, particularly after 5 years following RRSO. These results may inform counselling and management of carriers with respect to RRSO.
AB - Background The effect of risk-reducing salpingo-oophorectomy (RRSO) on breast cancer risk for BRCA1 and BRCA2 mutation carriers is uncertain. Retrospective analyses have suggested a protective effect but may be substantially biased. Prospective studies have had limited power, particularly for BRCA2 mutation carriers. Further, previous studies have not considered the effect of RRSO in the context of natural menopause. Methods A multi-centre prospective cohort of 2272 BRCA1 and 1605 BRCA2 mutation carriers was followed for a mean of 5.4 and 4.9 years, respectively; 426 women developed incident breast cancer. RRSO was modelled as a time-dependent covariate in Cox regression, and its effect assessed in premenopausal and postmenopausal women. Results There was no association between RRSO and breast cancer for BRCA1 (HR = 1.23; 95% CI 0.94-1.61) or BRCA2 (HR = 0.88; 95% CI 0.62-1.24) mutation carriers. For BRCA2 mutation carriers, HRs were 0.68 (95% CI 0.40-1.15) and 1.07 (95% CI 0.69-1.64) for RRSO carried out before or after age 45 years, respectively. The HR for BRCA2 mutation carriers decreased with increasing time since RRSO (HR = 0.51; 95% CI 0.26-0.99 for 5 years or longer after RRSO). Estimates for premenopausal women were similar. Conclusion We found no evidence that RRSO reduces breast cancer risk for BRCA1 mutation carriers. A potentially beneficial effect for BRCA2 mutation carriers was observed, particularly after 5 years following RRSO. These results may inform counselling and management of carriers with respect to RRSO.
KW - Breast cancer
KW - BRCA1
KW - BRCA2
KW - Mutation
KW - Risk-reducing salpingo-oophorectomy
KW - WOMEN
KW - METAANALYSIS
KW - ASSOCIATION
KW - CONSORTIUM
KW - REDUCTION
KW - SURVIVAL
KW - KCONFAB
KW - SURGERY
KW - OVARIAN
KW - LINK
U2 - 10.1186/s13058-020-1247-4
DO - 10.1186/s13058-020-1247-4
M3 - Article
VL - 22
JO - Breast cancer research
JF - Breast cancer research
SN - 1465-5411
IS - 1
M1 - 8
ER -
ID: 132894476