Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation

Amy P.M. Finch, Jan Lubinski, Pål Møller, Christian F. Singer, Beth Karlan, Leigha Senter, Barry Rosen, Lovise Maehle, Parviz Ghadirian, Cezary Cybulski, Tomasz Huzarski, Andrea Eisen, William D. Foulkes, Charmaine Kim-Sing, Peter Ainsworth, Nadine Tung, Henry T. Lynch, Susan Neuhausen, Kelly A. Metcalfe, Islay ThompsonJoan Murphy, Ping Sun, Steven A. Narod

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Abstract

Purpose: The purposes of this study were to estimate the reduction in risk of ovarian, fallopian tube, or peritoneal cancer in women with a BRCA1 or BRCA2 mutation after oophorectomy, by age of oophorectomy; to estimate the impact of prophylactic oophorectomy on all-cause mortality; and to estimate 5-year survival associated with clinically detected ovarian, occult, and peritoneal cancers diagnosed in the cohort. Patients and Methods: Women with a BRCA1 or BRCA2 mutation were identified from an international registry; 5,783 women completed a baseline questionnaire and ≥ one follow-up questionnaires. Women were observed until either diagnosis of ovarian, fallopian tube, or peritoneal cancer, death, or date of most recent follow-up. Hazard ratios (HRs) for cancer incidence and all-cause mortality associated with oophorectomy were evaluated using time-dependent survival analyses. Results: After an average follow-up period of 5.6 years, 186 women developed either ovarian (n = 132), fallopian (n = 22), or peritoneal (n = 32) cancer, of whom 68 have died. HR for ovarian, fallopian, or peritoneal cancer associated with bilateral oophorectomy was 0.20 (95% CI, 0.13 to 0.30; P <.001). Among women who had no history of cancer at baseline, HR for all-cause mortality to age 70 years associated with an oophorectomy was 0.23 (95% CI, 0.13 to 0.39; P <.001). Conclusion: Preventive oophorectomy was associated with an 80% reduction in the risk of ovarian, fallopian tube, or peritoneal cancer in BRCA1 or BRCA2 carriers and a 77% reduction in all-cause mortality.

Original languageEnglish (US)
Pages (from-to)1547-1553
Number of pages7
JournalJournal of Clinical Oncology
Volume32
Issue number15
DOIs
StatePublished - May 20 2014

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Finch, A. P. M., Lubinski, J., Møller, P., Singer, C. F., Karlan, B., Senter, L., Rosen, B., Maehle, L., Ghadirian, P., Cybulski, C., Huzarski, T., Eisen, A., Foulkes, W. D., Kim-Sing, C., Ainsworth, P., Tung, N., Lynch, H. T., Neuhausen, S., Metcalfe, K. A., ... Narod, S. A. (2014). Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. Journal of Clinical Oncology, 32(15), 1547-1553. https://doi.org/10.1200/JCO.2013.53.2820