Risk-reducing salpingo-oophorectomy and breast cancer risk in BRCA1 or BRCA2 mutation carriers: A systematic review and meta-analysis |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China;2. Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, China;1. Department of Medicine and Surgery, University of Parma, Parma, Italy;2. Dipartimento per le Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Department of Gynecology and Obstetrics, Roma, Italy;3. Department of Gynecologic Oncology, Gemelli Molise SpA, Campobasso, Italy;4. Department of Gynecologic Oncology, University of Palermo, Palermo, Italy;5. Department of Medicine and Health Science “V.Tiberio” Università degli Studi del Molise, Campobasso, Italy;1. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands;2. Department of Surgery, ETZ (Elisabeth-TweeSteden) Hospital, Tilburg, the Netherlands;3. Department of GROW, School for Developmental Biology & Oncology, Maastricht University, Maastricht, the Netherlands;12. Esq, USA;1. Department of Pathology and Laboratory Medicine, University of California, Los Angeles, USA;2. Department of Surgery, University of California, Los Angeles, USA;3. Department of Biomathematics, University of California, Los Angeles, USA;4. John Wayne Cancer Institute at Saint John''s Health Center, Santa Monica, CA, USA;5. Melanoma Institute Australia, Sydney, Australia;6. The University of Sydney, Sydney, Australia;7. The Angeles Clinic and Research Institute, Los Angeles, USA;8. Cedars Sinai Medical Center, Los Angeles, CA, USA;9. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, Australia;10. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;11. Binder Institute of Pathology, Affiliated Pathologists Medical Group, Hermosa Beach, CA, USA;1. Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, Padua, Italy;2. Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON, Canada;3. Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, Brescia, Italy;4. Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy;5. Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy;6. Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, “ASST Spedali Civili di Brescia”, University of Brescia, Brescia, Italy;7. Unit of Radiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, “ASST Spedali Civili di Brescia”, University of Brescia, Brescia, Italy;8. Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, Ontario, Canada;9. Department of Otolaryngology – Head and Neck Surgery/Surgical Oncology, University Health Network, Toronto, Ontario, Canada;10. Head & Neck Surgery, University College London Hospitals, London, United Kingdom;11. Department of Information Engineering, University of Brescia, Brescia, Italy;1. Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom;2. Regional Hepato-Pancreato-Biliary Unit, Manchester Royal Infirmary, Oxford Rd, Manchester, M13 9WL, United Kingdom;3. Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester, M13 9PL, United Kingdom;1. Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China;2. Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China;3. Department of Health Statistics, Second Military Medical University, Shanghai, China;4. Faculty of Hepato-Biliary-Pancreatic Surgery, The First Medical Center of Chinese People''s Liberation Army (PLA) General Hospital, Beijing, China;5. Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China;6. Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China |
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| Abstract: | ![]()
AimBRCA mutation carriers have a high lifetime risk of developing breast cancer (BC) and ovarian cancer (OC). Risk-reducing salpingo-oophorectomy (RRSO) has been shown to reduce OC risk. This meta-analysis was aim to analyze the effect of RRSO on the BC risk among BRCA1/2 mutation carriers.MethodsEmbase, PubMed, Web of Science, and Cochrane databases were searched for all studies investigating the effect of RRSO on BC risk. The pooled results were used to evaluate the association between RRSO and BC risk.ResultsThis meta-analysis included 13,965 BRCA1 and 7,057 BRCA2 mutation carriers from 14 observational studies. The pooled results showed that RRSO lowered BC risk among BRCA1 mutation carriers [hazard ratio (HR) = 0.63, 95% confidence interval (CI): 0.49–0.81, P < 0.01] and BRCA2 mutation carriers (HR = 0.51, 95% CI: 0.34–0.75, P < 0.01). RRSO reduced BC risk in younger women with BRCA1 mutation (HR = 0.48, 95% CI: 0.30–0.77, P < 0.01) and BRCA2 mutation (HR = 0.22, 95% CI: 0.08–0.65, P < 0.01). Analysis of the efficacy of RRSO at different time intervals after surgery showed a reduction of BC risk at <5 years after surgery in BRCA1 mutation carriers (HR = 0.60, 95% CI: 0.40–0.89, P = 0.01) and BRCA2 mutation carriers (HR = 0.42, 95% CI: 0.20–0.86, P = 0.02).ConclusionsRRSO is an effective way to reduce BC risk among women with BRCA1/2 mutation, especially in younger women. BRCA1/2 mutation carriers could benefit from RRSO in the immediate 5 years after surgery. |
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| Keywords: | Risk-reducing salpingo-oophorectomy Breast cancer risk BRCA1 BRCA2 meta-Analysis |
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