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Kauff ND , Domchek SM , Friebel TM , Robson ME , Lee J , Garber JE , Isaacs C , Evans DG , Lynch H , Eeles RA , Neuhausen SL , Daly MB , Matloff E , Blum JL , Sabbatini P , Barakat RR , Hudis C , Norton L , Offit K , Rebbeck TR
Risk-reducing salpingo-oophorectomy for the prevention of BRCA1- and BRCA2-associated breast and gynecologic cancer: A multicenter, prospective study
Journal of Clinical Oncology. 2008 Mar;26(8) :1331-1337
AbstractPurpose Risk-reducing salpingo-oophorectomy (RRSO) has been widely adopted as a key component of breast and gynecologic cancer risk-reduction for women with BRCA1 and BRCA2 mutations. Despite 17% to 39% of all BRCA mutation carriers having a mutation in BRCA2, no prospective study to date has evaluated the efficacy of RRSO for the prevention of breast and BRCA-associated gynecologic (ovarian, fallopian tube or primary peritoneal) cancer when BRCA2 mutation carriers are analyzed separately from BRCA1 mutation carriers. Patients and Methods A total of 1,079 women 30 years of age and older with ovaries in situ and a deleterious BRCA1 or BRCA2 mutation were enrolled onto prospective follow-up studies at one of 11 centers from November 1, 1994 to December 1, 2004. Women self-selected RRSO or observation. Follow-up information through November 30, 2005, was collected by questionnaire and medical record review. The effect of RRSO on time to diagnosis of breast or BRCA-associated gynecologic cancer was analyzed using a Cox proportional-hazards model. Results During 3-year follow-up, RRSO was associated with an 85% reduction in BRCA1-associated gynecologic cancer risk (hazard ratio [HR] = 0.15; 95% CI, 0.04 to 0.56) and a 72% reduction in BRCA2-associated breast cancer risk (HR = 0.28; 95% CI, 0.08 to 0.92). While protection against BRCA1-associated breast cancer (HR = 0.61; 95% CI, 0.30 to 1.22) and BRCA2-associated gynecologic cancer (HR = 0.00; 95% CI, not estimable) was suggested, neither effect reached statistical significance. Conclusion The protection conferred by RRSO against breast and gynecologic cancers may differ between carriers of BRCA1 and BRCA2 mutations. Further studies evaluating the efficacy of risk-reduction strategies in BRCA mutation carriers should stratify by the specific gene mutated.
NotesISI Document Delivery No.: 276XZ Times Cited: 0 Cited Reference Count: 35 Cited References: *NAT COMPR CANC NE, 2007, CLIN PRACT GUID ONC *SOC GYN ONC CLIN, 2005, GYNECOL ONCOL, V98, P179 ANTONIOU A, 2003, AM J HUM GENET, V72, P1117 BOYD J, 2000, JAMA-J AM MED ASSOC, V283, P2260 BURKE W, 1997, JAMA-J AM MED ASSOC, V277, P997 CHLEBOWSKI RT, 2002, J CLIN ONCOL, V20, P3328 COX DR, 1972, J ROY STAT SOC B MET, V34, P187 CUZICK J, 2003, LANCET, V361, P296 CUZICK J, 2005, J CLIN ONCOL, V23, P1636 DOMCHEK SM, 2006, LANCET ONCOL, V7, P223 EISEN A, 2005, J CLIN ONCOL, V23, P7491 FINCH A, 2006, JAMA-J AM MED ASSOC, V296, P185 FORD D, 1998, AM J HUM GENET, V62, P676 FOULKES WD, 2002, J NATL CANCER I, V94, P1504 FOULKES WD, 2004, CLIN CANCER RES, V10, P2029 HARTMANN LC, 2004, J CLIN ONCOL, V22, P981 HEDENFALK I, 2001, NEW ENGL J MED, V344, P539 KAUFF ND, 2002, NEW ENGL J MED, V346, P1609 KAUFF ND, 2007, J CLIN ONCOL, V25, P2921 KING MC, 2001, JAMA-J AM MED ASSOC, V286, P2251 KING MC, 2003, SCIENCE, V302, P643 KLAREN HM, 2003, J NATL CANCER I, V95, P941 KRAMER JL, 2005, J CLIN ONCOL, V23, P8629 LAKHANI SR, 2002, J CLIN ONCOL, V20, P2310 METCALFE K, 2004, J CLIN ONCOL, V22, P2328 NAROD SA, 2000, LANCET, V356, P1876 PONDER BAJ, 2000, BRIT J CANCER, V83, P1301 REBBECK TR, 1999, J NATL CANCER I, V91, P1475 REBBECK TR, 2002, NEW ENGL J MED, V346, P1616 REBBECK TR, 2005, J CLIN ONCOL, V23, P7804 RUTTER JL, 2003, J NATL CANCER I, V95, P1072 SATAGOPAN JM, 2002, CLIN CANCER RES, V8, P3776 SCHEUER L, 2002, J CLIN ONCOL, V20, P1260 STRUEWING JP, 1997, NEW ENGL J MED, V336, P1401 WOOSTER R, 2003, NEW ENGL J MED, V348, P2339 Kauff, Noah D. Domchek, Susan M. Friebel, Tara M. Robson, Mark E. Lee, Johanna Garber, Judy E. Isaacs, Claudine Evans, D. Gareth Lynch, Henry Eeles, Rosalind A. Neuhausen, Susan L. Daly, Mary B. Matloff, Ellen Blum, Joanne L. Sabbatini, Paul Barakat, Richard R. Hudis, Clifford Norton, Larry Offit, Kenneth Rebbeck, Timothy R. AMER SOC CLINICAL ONCOLOGY; 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA