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Multicenter Study
. 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

Amy P M Finch  1 , Jan Lubinski  1 , Pål Møller  1 , Christian F Singer  1 , Beth Karlan  1 , Leigha Senter  1 , Barry Rosen  1 , Lovise Maehle  1 , Parviz Ghadirian  1 , Cezary Cybulski  1 , Tomasz Huzarski  1 , Andrea Eisen  1 , William D Foulkes  1 , Charmaine Kim-Sing  1 , Peter Ainsworth  1 , Nadine Tung  1 , Henry T Lynch  1 , Susan Neuhausen  1 , Kelly A Metcalfe  1 , Islay Thompson  1 , Joan Murphy  1 , Ping Sun  1 , Steven A Narod  2
Affiliations
Multicenter Study

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

Amy P M Finch et al. J Clin Oncol. .

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.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Five-year survival after cancer in BRCA1 or BRCA2 mutation carriers by type of cancer.
See this image and copyright information in PMC

Comment in

References

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