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J Clin Oncol. 2014 May 20;32(15):1547-53. doi: 10.1200/JCO.2013.53.2820. Epub 2014 Feb 24.

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

Author information

  • 1Amy P.M. Finch, Barry Rosen, Andrea Eisen, Kelly A. Metcalfe, Islay Thompson, Joan Murphy, Ping Sun, and Steven A. Narod, University of Toronto; Barry Rosen and Joan Murphy, Princess Margaret Hospital; Amy P.M. Finch, Islay Thompson, Ping Sun, and Steven A. Narod, Women's College Research Institute; Andrea Eisen, Sunnybrook Odette Cancer Center, Toronto; Peter Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, University of Montreal Hospital Centre; William D. Foulkes, McGill University, Montreal, Quebec; Charmaine Kim-Sing, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Jan Lubinski, Cezary Cybulski, and Tomasz Huzarski, Pomeranian Medical University, Szczecin, Poland; Pål Møller and Lovise Maehle, Norwegian Radium Hospital and Oslo University Hospital, Oslo, Norway; Christian F. Singer, Medical University of Vienna, Vienna, Austria; Beth Karlan, Cedars-Sinai Medical Center, Beverly Hills; Susan Neuhausen, City of Hope National Medical Center, Duarte, CA; Leigha Senter, Ohio State University Medical Center, Columbus, OH; Nadine Tung, Beth Israel Deaconess Medical Center, Boston, MA; and Henry T. Lynch, Creighton University School of Medicine, Omaha, NE.
  • 2Amy P.M. Finch, Barry Rosen, Andrea Eisen, Kelly A. Metcalfe, Islay Thompson, Joan Murphy, Ping Sun, and Steven A. Narod, University of Toronto; Barry Rosen and Joan Murphy, Princess Margaret Hospital; Amy P.M. Finch, Islay Thompson, Ping Sun, and Steven A. Narod, Women's College Research Institute; Andrea Eisen, Sunnybrook Odette Cancer Center, Toronto; Peter Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, University of Montreal Hospital Centre; William D. Foulkes, McGill University, Montreal, Quebec; Charmaine Kim-Sing, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Jan Lubinski, Cezary Cybulski, and Tomasz Huzarski, Pomeranian Medical University, Szczecin, Poland; Pål Møller and Lovise Maehle, Norwegian Radium Hospital and Oslo University Hospital, Oslo, Norway; Christian F. Singer, Medical University of Vienna, Vienna, Austria; Beth Karlan, Cedars-Sinai Medical Center, Beverly Hills; Susan Neuhausen, City of Hope National Medical Center, Duarte, CA; Leigha Senter, Ohio State University Medical Center, Columbus, OH; Nadine Tung, Beth Israel Deaconess Medical Center, Boston, MA; and Henry T. Lynch, Creighton University School of Medicine, Omaha, NE. steven.narod@wchospital.ca.

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.

© 2014 by American Society of Clinical Oncology.

PMID:
24567435
[PubMed - indexed for MEDLINE]
PMCID:
PMC4026578
Free PMC Article
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