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12.02.2019 | Epidemiology

Oophorectomy and risk of contralateral breast cancer among BRCA1 and BRCA2 mutation carriers

Zeitschrift:
Breast Cancer Research and Treatment
Autoren:
Joanne Kotsopoulos, Jan Lubinski, Henry T. Lynch, Nadine Tung, Susan Armel, Leigha Senter, Christian F. Singer, Robert Fruscio, Fergus Couch, Jeffrey N. Weitzel, Beth Karlan, William D. Foulkes, Pal Moller, Andrea Eisen, Peter Ainsworth, Susan L. Neuhausen, Olufunmilayo Olopade, Ping Sun, Jacek Gronwald, Steven A. Narod, the Hereditary Breast Cancer Clinical Study Group
Wichtige Hinweise
The other members of the Hereditary Breast Cancer Clinical Study Group are listed in the Acknowledgments.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Following a diagnosis of breast cancer, BRCA mutation carriers face an increased risk of developing a second (contralateral) cancer in the unaffected breast. It is important to identify predictors of contralateral cancer in order to make informed decisions about bilateral mastectomy. The impact of bilateral salpingo-oophorectomy (i.e., oophorectomy) on the risk of developing contralateral breast cancer is unclear. Thus, we conducted a prospective study of the relationship between oophorectomy and the risk of contralateral breast cancer in 1781 BRCA1 and 503 BRCA2 mutation carriers with breast cancer.

Methods

Women were followed from the date of diagnosis of their first breast cancer until the date of diagnosis of a contralateral breast cancer, bilateral mastectomy, date of death, or date of last follow-up. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of contralateral breast cancer associated with oophorectomy. Oophorectomy was included as a time-dependent covariate. We performed a left-censored analysis for those women who reported a primary breast cancer prior to study entry (i.e., from completion of baseline questionnaire).

Results

After an average of 9.8 years of follow-up, there were 179 (7.8%) contralateral breast cancers diagnosed. Oophorectomy was not associated with the risk of developing a second breast cancer (HR 0.92; 95% CI 0.68–1.25). The relationship did not vary by BRCA mutation type or by age at diagnosis of the first breast cancer. There was some evidence for a decreased risk of contralateral breast cancer among women with an ER-positive primary breast cancer, but this was based on a small number of events (n = 240).

Conclusion

Overall, our findings suggest that oophorectomy has little impact on the risk of contralateral breast cancer.

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