Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: The PROSE study group

Timothy R. Rebbeck, Tara Friebel, Henry T. Lynch, Susan L. Neuhausen, Laura Van't Veer, Judy E. Garber, Gareth R. Evans, Steven A. Narod, Claudine Isaacs, Ellen Matloff, Mary B. Daly, Olufunmilayo I. Olopade, Barbara L. Weber

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Abstract

Purpose: Data on the efficacy of bilateral prophylactic mastectomy for breast cancer risk reduction in women with BRCA1 and BRCA2 (BRCA1/2) mutations are limited, despite the clinical use of this risk-management strategy. Thus, we estimated the degree of breast cancer risk reduction after surgery in women who carry these mutations. Patients and Methods: Four hundred eighty-three women with disease-associated germline BRCA1/2 mutations were studied for the occurrence of breast cancer. Cases were mutation carriers who underwent bilateral prophylactic mastectomy and who were followed prospectively from the time of their center ascertainment and their surgery, with analyses performed for both follow-up periods. Controls were BRCA1/2 mutation carriers with no history of bilateral prophylactic mastectomy matched to cases on gene, center, and year of birth. Both cases and controls were excluded for previous or concurrent diagnosis of breast cancer. Analyses were adjusted for duration of endogenous ovarian hormone exposure, including age at bilateral prophylactic oophorectomy if applicable. Results: Breast cancer was diagnosed in two (1.9%) of 105 women who had bilateral prophylactic mastectomy and in 184 (48.7%) of 378 matched controls who did not have the procedure, with a mean follow-up of 6.4 years. Bilateral prophylactic mastectomy reduced the risk of breast cancer by approximately 95% in women with prior or concurrent bilateral prophylactic oophorectomy and by approximately 90% in women with intact ovaries. Conclusion: Bilateral prophylactic mastectomy reduces the risk of breast cancer in women with BRCA1/2 mutations by approximately 90%.

Original languageEnglish
Pages (from-to)1055-1062
Number of pages8
JournalJournal of Clinical Oncology
Volume22
Issue number6
DOIs
StatePublished - 2004

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Breast Neoplasms
Mutation
Ovariectomy
Risk Reduction Behavior
Birthing Centers
Risk Management
Prophylactic Mastectomy
Ovary
Hormones
Genes

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers : The PROSE study group. / Rebbeck, Timothy R.; Friebel, Tara; Lynch, Henry T.; Neuhausen, Susan L.; Van't Veer, Laura; Garber, Judy E.; Evans, Gareth R.; Narod, Steven A.; Isaacs, Claudine; Matloff, Ellen; Daly, Mary B.; Olopade, Olufunmilayo I.; Weber, Barbara L.

In: Journal of Clinical Oncology, Vol. 22, No. 6, 2004, p. 1055-1062.

Research output: Contribution to journalArticle

Rebbeck, TR, Friebel, T, Lynch, HT, Neuhausen, SL, Van't Veer, L, Garber, JE, Evans, GR, Narod, SA, Isaacs, C, Matloff, E, Daly, MB, Olopade, OI & Weber, BL 2004, 'Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: The PROSE study group', Journal of Clinical Oncology, vol. 22, no. 6, pp. 1055-1062. https://doi.org/10.1200/JCO.2004.04.188
Rebbeck, Timothy R. ; Friebel, Tara ; Lynch, Henry T. ; Neuhausen, Susan L. ; Van't Veer, Laura ; Garber, Judy E. ; Evans, Gareth R. ; Narod, Steven A. ; Isaacs, Claudine ; Matloff, Ellen ; Daly, Mary B. ; Olopade, Olufunmilayo I. ; Weber, Barbara L. / Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers : The PROSE study group. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 6. pp. 1055-1062.
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title = "Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: The PROSE study group",
abstract = "Purpose: Data on the efficacy of bilateral prophylactic mastectomy for breast cancer risk reduction in women with BRCA1 and BRCA2 (BRCA1/2) mutations are limited, despite the clinical use of this risk-management strategy. Thus, we estimated the degree of breast cancer risk reduction after surgery in women who carry these mutations. Patients and Methods: Four hundred eighty-three women with disease-associated germline BRCA1/2 mutations were studied for the occurrence of breast cancer. Cases were mutation carriers who underwent bilateral prophylactic mastectomy and who were followed prospectively from the time of their center ascertainment and their surgery, with analyses performed for both follow-up periods. Controls were BRCA1/2 mutation carriers with no history of bilateral prophylactic mastectomy matched to cases on gene, center, and year of birth. Both cases and controls were excluded for previous or concurrent diagnosis of breast cancer. Analyses were adjusted for duration of endogenous ovarian hormone exposure, including age at bilateral prophylactic oophorectomy if applicable. Results: Breast cancer was diagnosed in two (1.9{\%}) of 105 women who had bilateral prophylactic mastectomy and in 184 (48.7{\%}) of 378 matched controls who did not have the procedure, with a mean follow-up of 6.4 years. Bilateral prophylactic mastectomy reduced the risk of breast cancer by approximately 95{\%} in women with prior or concurrent bilateral prophylactic oophorectomy and by approximately 90{\%} in women with intact ovaries. Conclusion: Bilateral prophylactic mastectomy reduces the risk of breast cancer in women with BRCA1/2 mutations by approximately 90{\%}.",
author = "Rebbeck, {Timothy R.} and Tara Friebel and Lynch, {Henry T.} and Neuhausen, {Susan L.} and {Van't Veer}, Laura and Garber, {Judy E.} and Evans, {Gareth R.} and Narod, {Steven A.} and Claudine Isaacs and Ellen Matloff and Daly, {Mary B.} and Olopade, {Olufunmilayo I.} and Weber, {Barbara L.}",
year = "2004",
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TY - JOUR

T1 - Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers

T2 - The PROSE study group

AU - Rebbeck, Timothy R.

AU - Friebel, Tara

AU - Lynch, Henry T.

AU - Neuhausen, Susan L.

AU - Van't Veer, Laura

AU - Garber, Judy E.

AU - Evans, Gareth R.

AU - Narod, Steven A.

AU - Isaacs, Claudine

AU - Matloff, Ellen

AU - Daly, Mary B.

AU - Olopade, Olufunmilayo I.

AU - Weber, Barbara L.

PY - 2004

Y1 - 2004

N2 - Purpose: Data on the efficacy of bilateral prophylactic mastectomy for breast cancer risk reduction in women with BRCA1 and BRCA2 (BRCA1/2) mutations are limited, despite the clinical use of this risk-management strategy. Thus, we estimated the degree of breast cancer risk reduction after surgery in women who carry these mutations. Patients and Methods: Four hundred eighty-three women with disease-associated germline BRCA1/2 mutations were studied for the occurrence of breast cancer. Cases were mutation carriers who underwent bilateral prophylactic mastectomy and who were followed prospectively from the time of their center ascertainment and their surgery, with analyses performed for both follow-up periods. Controls were BRCA1/2 mutation carriers with no history of bilateral prophylactic mastectomy matched to cases on gene, center, and year of birth. Both cases and controls were excluded for previous or concurrent diagnosis of breast cancer. Analyses were adjusted for duration of endogenous ovarian hormone exposure, including age at bilateral prophylactic oophorectomy if applicable. Results: Breast cancer was diagnosed in two (1.9%) of 105 women who had bilateral prophylactic mastectomy and in 184 (48.7%) of 378 matched controls who did not have the procedure, with a mean follow-up of 6.4 years. Bilateral prophylactic mastectomy reduced the risk of breast cancer by approximately 95% in women with prior or concurrent bilateral prophylactic oophorectomy and by approximately 90% in women with intact ovaries. Conclusion: Bilateral prophylactic mastectomy reduces the risk of breast cancer in women with BRCA1/2 mutations by approximately 90%.

AB - Purpose: Data on the efficacy of bilateral prophylactic mastectomy for breast cancer risk reduction in women with BRCA1 and BRCA2 (BRCA1/2) mutations are limited, despite the clinical use of this risk-management strategy. Thus, we estimated the degree of breast cancer risk reduction after surgery in women who carry these mutations. Patients and Methods: Four hundred eighty-three women with disease-associated germline BRCA1/2 mutations were studied for the occurrence of breast cancer. Cases were mutation carriers who underwent bilateral prophylactic mastectomy and who were followed prospectively from the time of their center ascertainment and their surgery, with analyses performed for both follow-up periods. Controls were BRCA1/2 mutation carriers with no history of bilateral prophylactic mastectomy matched to cases on gene, center, and year of birth. Both cases and controls were excluded for previous or concurrent diagnosis of breast cancer. Analyses were adjusted for duration of endogenous ovarian hormone exposure, including age at bilateral prophylactic oophorectomy if applicable. Results: Breast cancer was diagnosed in two (1.9%) of 105 women who had bilateral prophylactic mastectomy and in 184 (48.7%) of 378 matched controls who did not have the procedure, with a mean follow-up of 6.4 years. Bilateral prophylactic mastectomy reduced the risk of breast cancer by approximately 95% in women with prior or concurrent bilateral prophylactic oophorectomy and by approximately 90% in women with intact ovaries. Conclusion: Bilateral prophylactic mastectomy reduces the risk of breast cancer in women with BRCA1/2 mutations by approximately 90%.

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DO - 10.1200/JCO.2004.04.188

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JF - Journal of Clinical Oncology

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