Abstract
Background: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. Methods: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n=3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable). All statistical tests were two-sided. Results: Over a mean follow-up of 5.6 years, 350 new breast cancers were diagnosed. Among women with a BRCA1 or BRCA2 mutation, oophorectomy was not associated with breast cancer risk compared with women who did not undergo an oophorectomy. The age-adjusted hazard ratio associated with oophorectomy was 0.96 (95% CI=0.73 to 1.26, P=.76) for BRCA1 and was 0.65 (95% CI=0.37 to 1.16, P=.14) for BRCA2 mutation carriers. In stratified analyses, the effect of oophorectomy was statistically significant for breast cancer in BRCA2 mutation carriers diagnosed prior to age 50 years (age-adjusted HR=0.18, 95% CI=0.05 to 0.63, P=.007). Oophorectomy was not associated with risk of breast cancer prior to age 50 years among BRCA1 mutation carriers (age-adjusted HR=0.79, 95% CI=0.55 to 1.13, P=.51). Conclusions: Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.
| Original language | English (US) |
|---|---|
| Article number | djw177 |
| Journal | Journal of the National Cancer Institute |
| Volume | 109 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2017 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
- Oncology
- Cancer Research
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Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers. / Hereditary Breast Cancer Clinical Study Group.
In: Journal of the National Cancer Institute, Vol. 109, No. 1, djw177, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers
AU - Hereditary Breast Cancer Clinical Study Group
AU - Kotsopoulos, Joanne
AU - Huzarski, Tomasz
AU - Gronwald, Jacek
AU - Singer, Christian F.
AU - Moller, Pal
AU - Lynch, Henry T.
AU - Armel, Susan
AU - Karlan, Beth
AU - Foulkes, William D.
AU - Neuhausen, Susan L.
AU - Senter, Leigha
AU - Tung, Nadine
AU - Weitzel, Jeffrey N.
AU - Eisen, Andrea
AU - Metcalfe, Kelly
AU - Eng, Charis
AU - Pal, Tuya
AU - Evans, Gareth
AU - Sun, Ping
AU - Lubinski, Jan
AU - Narod, Steven A.
PY - 2017
Y1 - 2017
N2 - Background: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. Methods: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n=3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable). All statistical tests were two-sided. Results: Over a mean follow-up of 5.6 years, 350 new breast cancers were diagnosed. Among women with a BRCA1 or BRCA2 mutation, oophorectomy was not associated with breast cancer risk compared with women who did not undergo an oophorectomy. The age-adjusted hazard ratio associated with oophorectomy was 0.96 (95% CI=0.73 to 1.26, P=.76) for BRCA1 and was 0.65 (95% CI=0.37 to 1.16, P=.14) for BRCA2 mutation carriers. In stratified analyses, the effect of oophorectomy was statistically significant for breast cancer in BRCA2 mutation carriers diagnosed prior to age 50 years (age-adjusted HR=0.18, 95% CI=0.05 to 0.63, P=.007). Oophorectomy was not associated with risk of breast cancer prior to age 50 years among BRCA1 mutation carriers (age-adjusted HR=0.79, 95% CI=0.55 to 1.13, P=.51). Conclusions: Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.
AB - Background: Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. Methods: Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n=3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable). All statistical tests were two-sided. Results: Over a mean follow-up of 5.6 years, 350 new breast cancers were diagnosed. Among women with a BRCA1 or BRCA2 mutation, oophorectomy was not associated with breast cancer risk compared with women who did not undergo an oophorectomy. The age-adjusted hazard ratio associated with oophorectomy was 0.96 (95% CI=0.73 to 1.26, P=.76) for BRCA1 and was 0.65 (95% CI=0.37 to 1.16, P=.14) for BRCA2 mutation carriers. In stratified analyses, the effect of oophorectomy was statistically significant for breast cancer in BRCA2 mutation carriers diagnosed prior to age 50 years (age-adjusted HR=0.18, 95% CI=0.05 to 0.63, P=.007). Oophorectomy was not associated with risk of breast cancer prior to age 50 years among BRCA1 mutation carriers (age-adjusted HR=0.79, 95% CI=0.55 to 1.13, P=.51). Conclusions: Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.
UR - http://www.scopus.com/inward/record.url?scp=85014834392&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85014834392&partnerID=8YFLogxK
U2 - 10.1093/jnci/djw177
DO - 10.1093/jnci/djw177
M3 - Article
C2 - 27601060
AN - SCOPUS:85014834392
VL - 109
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
SN - 0027-8874
IS - 1
M1 - djw177
ER -