Friebel, T. M., Domchek, S. M., Neuhausen, S. L., Wagner, T., Evans, D. G., Isaacs, C., Garber, J. E., Daly, M. B., Eeles, R., Matloff, E., Tomlinson, G., Lynch, H. T., Tung, N., Blum, J. L., Weitzel, J., Rubinstein, W. S., Ganz, P. A., Couch, F., Rebbeck, T. R. (2007) Bilateral prophylactic oophorectomy and bilateral prophylactic mastectomy in a prospective cohort of unaffected BRCA1 and BRCA2 mutation carriers. CLINICAL BREAST CANCER, 7 (11). pp. 875-882. ISSN 1526-8209

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Abstract

Background: Women with BRCA1 or BRCA2 (BRCA1/2) mutations can reduce cancer incidence and mortality by using bilateral prophylactic oophorectomy (BPO) or bilateral prophylactic mastectomy (BPM). The availability of these risk-reduction strategies is an important consideration in the decision to undergo genetic testing. Patients and Methods: We evaluated the use of BPO and BPM in a prospective sample of 537 female BRCA1/2 mutation carriers from 17 centers in North America and Europe. These women were aged > 30 years, had no BPM, BPO, breast cancer, or ovarian cancer before the disclosure of their genetic test results and were followed for > 6 months. Results: Bilateral prophylactic oophorectomy is used significantly more frequently than BPM (55% vs. 21%; P < .001). Bilateral prophylactic oophorectomy was more common among women age >= 40 years compared with women aged < 40 years (68% vs. 43%; P < .001) and among porous women compared with nulliparous women (60% vs. 39%; P < .001). There was no difference in BPM (P = .83) or BPO (P = .09) in BRCA1 versus BRCA2 carriers. Multivariate models identified age and parity as a predictor of BPO in BRCA1 carriers; age and ovarian cancer family history in BRCA2 carriers; parity and ovarian cancer family history as a predictor of BPM in BRCA1 carriers; and smoking and ovarian cancer family history in BRCA2 carriers. Conclusion: Bilateral prophylactic oophorectomy is more commonly used than BPM in unaffected BRCA1/2 mutation carriers. Parity, age, and family history can also influence BPO and BPM uptake. Consistent with current recommendations, BPO is used by the majority of porous women aged > 40 years.

Item Type:	Article
Authors (ICR Faculty only):	Eeles, Rosalind
All Authors:	Friebel, T. M., Domchek, S. M., Neuhausen, S. L., Wagner, T., Evans, D. G., Isaacs, C., Garber, J. E., Daly, M. B., Eeles, R., Matloff, E., Tomlinson, G., Lynch, H. T., Tung, N., Blum, J. L., Weitzel, J., Rubinstein, W. S., Ganz, P. A., Couch, F., Rebbeck, T. R.
Uncontrolled Keywords:	genetic testing; hereditary breast cancer; surgery BREAST-CANCER RISK; SALPINGO-OOPHORECTOMY; OVARIAN-CANCER; PREVENTIVE MEASURES; GENE MUTATION; WOMEN; SURGERY; POPULATION
Research teams:	ICR divisions > Genetics and Epidemiology > Oncogenetics ICR divisions > Radiotherapy and Imaging > Oncogenetics
Depositing User:	Users 10 not found.
Date Deposited:	10 Jun 2008 10:54
Last Modified:	10 Feb 2010 11:50
URI:	http://publications.icr.ac.uk/id/eprint/6286

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