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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2013

01-12-2013 | Epidemiology

Risk-reducing surgery increases survival in BRCA1/2 mutation carriers unaffected at time of family referral

Authors: Sarah L. Ingham, Matthew Sperrin, Andrew Baildam, Gary L. Ross, Richard Clayton, Fiona Lalloo, Iain Buchan, Anthony Howell, D. Gareth R. Evans

Published in: Breast Cancer Research and Treatment | Issue 3/2013

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Abstract

The aim of this study was to establish if risk-reducing surgery (RRS) increases survival among BRCA1/2 carriers without breast/ovarian cancer at the time of family referral. Female BRCA1/2 carriers were identified from the Manchester Genetic Medicine Database. Those patients alive and unaffected at the date of first family ascertainment were included in this study. Female first-degree relatives (FDRs) without predictive genetic testing who otherwise met eligibility criteria were also included. The effect of breast and ovarian RRS on survival was analysed. The survival experiences of RRS and non-RRS patients, stratified by BRCA status, were examined with Kaplan–Meier curves and contrasted using log-rank tests and Cox models. 691 female BRCA1/2 mutation carriers without breast or ovarian cancer at time of family ascertainment were identified; 346 BRCA1 and 345 BRCA2. 105 BRCA1 carriers and 122 BRCA2 carriers developed breast cancer during follow-up. The hazard of death was statistically significantly lower (P < 0.001) following RRS versus no RRS. 10-year survival for women having RRS was 98.9 % (92.4–99.8 %) among BRCA1 and 98.0 % (92.2–99.5 %) among BRCA2 carriers. This survival benefit with RRS remained significant after FDRs were added. Women who had any form of RRS had increased survival compared to those who did not have RRS; a further increase in survival was seen among women who had both types of surgery. However, formal evidence for a survival advantage from bilateral mastectomy alone requires further research.
Appendix
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Metadata
Title
Risk-reducing surgery increases survival in BRCA1/2 mutation carriers unaffected at time of family referral
Authors
Sarah L. Ingham
Matthew Sperrin
Andrew Baildam
Gary L. Ross
Richard Clayton
Fiona Lalloo
Iain Buchan
Anthony Howell
D. Gareth R. Evans
Publication date
01-12-2013
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2013
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-013-2765-x

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