Risk-reducing mastectomy and breast cancer mortality in women with a BRCA1 or BRCA2 pathogenic variant: an international analysis

Background Risk-reducing mastectomy (RRM) is offered to women with a BRCA1 or BRCA2 pathogenic variant, however, there are limited data on the impact on breast cancer mortality. Methods Participants were identified from a registry of women with BRCA1/2 pathogenic variants. We used a pseudo-randomise...

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Veröffentlicht in:British journal of cancer 2024-02, Vol.130 (2), p.269-274
Hauptverfasser: Metcalfe, Kelly, Huzarski, Tomasz, Gronwald, Jacek, Kotsopoulos, Joanne, Kim, Raymond, Moller, Pal, Pal, Tuya, Aeilts, Amber, Eisen, Andrea, Karlan, Beth, Bordeleau, Louise, Tung, Nadine, Olopade, Olufunmilayo, Zakalik, Dana, Singer, Christian F., Foulkes, William, Couch, Fergus, Neuhausen, Susan L., Eng, Charis, Sun, Ping, Lubinski, Jan, Narod, Steven A.
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Sprache:eng
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Zusammenfassung:Background Risk-reducing mastectomy (RRM) is offered to women with a BRCA1 or BRCA2 pathogenic variant, however, there are limited data on the impact on breast cancer mortality. Methods Participants were identified from a registry of women with BRCA1/2 pathogenic variants. We used a pseudo-randomised trial design and matched one woman with a RRM to one woman without a RRM on year of birth, gene, and country. We estimated the hazard ratio (HR) and 95% confidence intervals (CI) for dying of breast cancer in the follow-up period. Results There were 1654 women included; 827 assigned to the RRM arm and 827 assigned to the control arm. After a mean follow-up of 6.3 years, there were 20 incident breast cancers (including 15 occult cancers) and two breast cancer deaths in the RRM arm, and 100 incident breast cancers and 7 breast cancer deaths in the control arm (HR = 0.26; 95% CI 0.05–1.35; p  = 0.11). The probability of dying of breast cancer within 15 years after RRM was 0.95%. Conclusions In women with a BRCA1 or BRCA2 pathogenic variant, RRM reduces the risk of breast cancer, and the probability of dying of breast cancer is low.
ISSN:0007-0920
1532-1827
1532-1827
DOI:10.1038/s41416-023-02503-8