DOI: 10.1097/01.COT.0000316107.81591.05

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Issn Print: 0276-2234

Publication Date: 2006/08/10


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Cancer Risk Reduction after Oophorectomy Differs for BRCA1, BRCA2

Robert H. Carlson

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Excerpt

ATLANTA—Risk-reducing salpingo-oophorectomy is known to lower the risk of subsequent breast and gynecological cancers in women with both BRCA1 and BRCA2 mutations. But a prospective analysis following women for up to 40 months after the procedure showed that women with BRCA1 mutations had a greater reduction in ovarian cancer risk, while those with BRCA2 mutations had a bigger decrease in breast cancer risk.
The study, presented here at the ASCO Annual Meeting by Noah D. Kauff, MD, Assistant Attending Physician in the Clinical Genetics and Gynecology Services of Memorial Sloan-Kettering Cancer Center, showed a 90% reduction in the incidence of gynecologic cancer and a 47% reduction in the incidence of breast cancer when BRCA1 and BRCA2 mutation carriers were included.
But when the two groups were analyzed separately, risk-reducing salpingo-oophorectomy lowered the incidence of breast cancer significantly only in BRCA2 mutation carriers, by 72%, compared with a non-statistically significant 39% reduction in the incidence of breast cancer in BRCA1 mutation carriers.
Furthermore, there was a trend toward more estrogen receptor (ER)-positive breast cancer risk reduction with the procedure compared with ER-negative breast cancer.
This is the first study showing that BRCA1 mutation carriers do not reduce the risk of subsequent breast cancer after ovariectomy, and it supports the hypothesis that BRCA1-related and BRCA2-related breast cancers are different cancers and may require different preventive approaches, Dr. Kauff and his coauthors said.
The study included combined follow-up data from two large prospective cohorts of BRCA mutation carriers (Kauff et al: NEJM 2002;346:1609–1615 and Rebbeck et al: NEJM 2002;346: 1616–1622).
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