Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk: an international prospective cohort of BRCA1 and BRCA2 mutation carriers
Creators: name: Mavaddat, Nasim
name: Antoniou, Antonis C.
name: Mooij, Thea M.
name: Hooning, Maartje J.
name: Heemskerk-Gerritsen, Bernadette A.
name: Noguès, Catherine
name: Gauthier-Villars, Marion
name: Caron, Olivier
name: Gesta, Paul
name: Pujol, Pascal
name: Lortholary, Alain
name: Barrowdale, Daniel
name: Frost, Debra
name: Evans, D. Gareth
name: Izatt, Louise
name: Adlard, Julian
name: Eeles, Ros
name: Brewer, Carole
name: Tischkowitz, Marc
name: Henderson, Alex
name: Cook, Jackie
name: Eccles, Diana
name: Van Engelen, Klaartje
name: Mourits, Marian J. E.
name: Ausems, Margreet G. E. M.
name: Koppert, Linetta B.
name: Hopper, John L.
name: John, Esther M.
name: Chung, Wendy K.
name: Andrulis, Irene L.
name: Daly, Mary B.
name: Buys, Saundra S.
name: Benitez, Javier
name: Caldes, Trinidad
name: Jakubowska, Anna
name: Simard, Jacques
name: Singer, Christian F.
name: Tan, Yen
name: Olah, Edith
name: Navratilova, Marie
name: Foretova, Lenka
name: Gerdes, Anne-Marie
name: Roos-Blom, Marie-José
name: Van Leeuwen, Flora E.
name: Arver, Brita
name: Olsson, Håkan
name: Schmutzler, Rita K.
name: Engel, Christoph
name: Kast, Karin
name: Phillips, Kelly-Anne
name: Terry, Mary Beth
name: Milne, Roger L.
name: Goldgar, David E.
name: Rookus, Matti A.
name: Andrieu, Nadine
name: Easton, Douglas F.
name: Laborde, Lilian
name: Breysse, Emmanuel
name: Stoppa-Lyonnet, Dominique
name: Buecher, Bruno
name: Fourme-Mouret, Emmanuelle
name: Fricker, Jean-Pierre
name: Lasset, Christine
name: Bonadona, Valérie
name: Berthet, Pascaline
name: Faivre, Laurence
name: Luporsi, Elisabeth
name: Mari, Véronique
name: Gladieff, Laurence
name: Sobol, Hagay
name: Eisinger, François
name: Longy, Michel
name: Dugast, Catherine
name: Colas, Chrystelle
name: Coupier, Isabelle
name: Corsini, Carole
name: Vennin, Philippe
name: Adenis, Claude
name: Nguyen, Tan Dat
name: Delnatte, Capucine
name: Tinat, Julie
name: Tennevet, Isabelle
name: Limacher, Jean-Marc
name: Maugard, Christine
name: Bignon, Yves-Jean
name: Demange, Liliane
name: Penet, Clotilde
name: Dreyfus, Hélène
name: Cohen-Haguenauer, Odile
name: Venat-Bouvet, Laurence
name: Leroux, Dominique
name: Zattara-Cannoni, Hélène
name: Fert-Ferrer, Sandra
name: Bera, Odile
name: Ellis, Steve
name: Hogervorst, F. B. L.
name: Collée, J. M.
name: Van Asperen, C. J.
name: Mensenkamp, A. R.
name: Ausems, M. G. E. M.
name: Meijers-Heijboer, H. E. J.
name: Van Engelen, K.
name: Blok, M. J.
name: Oosterwijk, J. C.
name: Verloop, J.
name: Van Den Broek, E.
Publisher: name: Apollo - University of Cambridge Repository
Year: 2020
Subjects: Research Article
Breast cancer
BRCA1
BRCA2
Mutation
Risk-reducing salpingo-oophorectomy

description: Abstract: Background: The effect of risk-reducing salpingo-oophorectomy (RRSO) on breast cancer risk for BRCA1 and BRCA2 mutation carriers is uncertain. Retrospective analyses have suggested a protective effect but may be substantially biased. Prospective studies have had limited power, particularly for BRCA2 mutation carriers. Further, previous studies have not considered the effect of RRSO in the context of natural menopause. Methods: A multi-centre prospective cohort of 2272 BRCA1 and 1605 BRCA2 mutation carriers was followed for a mean of 5.4 and 4.9 years, respectively; 426 women developed incident breast cancer. RRSO was modelled as a time-dependent covariate in Cox regression, and its effect assessed in premenopausal and postmenopausal women. Results: There was no association between RRSO and breast cancer for BRCA1 (HR = 1.23; 95% CI 0.94–1.61) or BRCA2 (HR = 0.88; 95% CI 0.62–1.24) mutation carriers. For BRCA2 mutation carriers, HRs were 0.68 (95% CI 0.40–1.15) and 1.07 (95% CI 0.69–1.64) for RRSO carried out before or after age 45 years, respectively. The HR for BRCA2 mutation carriers decreased with increasing time since RRSO (HR = 0.51; 95% CI 0.26–0.99 for 5 years or longer after RRSO). Estimates for premenopausal women were similar. Conclusion: We found no evidence that RRSO reduces breast cancer risk for BRCA1 mutation carriers. A potentially beneficial effect for BRCA2 mutation carriers was observed, particularly after 5 years following RRSO. These results may inform counselling and management of carriers with respect to RRSO.