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PMID: 19141781 Published · ppublish English Journal Article Meta-Analysis Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers.

Journal of the National Cancer Institute ·Vol. 101 ·No. 2 ·2009-01-21 ·Pages 80-7

Rebbeck TR, Kauff ND, Domchek SM

Abstract

Risk-reducing salpingo-oophorectomy (RRSO) is widely used by carriers of BRCA1 or BRCA2 (BRCA1/2) mutations to reduce their risks of breast and ovarian cancer. To guide women and their clinicians in optimizing cancer prevention strategies, we summarized the magnitude of the risk reductions in women with BRCA1/2 mutations who have undergone RRSO compared with those who have not. All reports of RRSO and breast and/or ovarian or fallopian tube cancer in BRCA1/2 mutation carriers published between 1999 and 2007 were obtained from a PubMed search. Hazard ratio (HR) estimates were identified directly from the original articles. Pooled results were computed from nonoverlapping studies by fixed-effects meta-analysis. Ten studies investigated breast or gynecologic cancer outcomes in BRCA1/2 mutation carriers who had undergone RRSO. Breast cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers, four of BRCA1 mutation carriers, and three of BRCA2 mutation carriers. Gynecologic cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers and one of BRCA1 mutation carriers. RRSO was associated with a statistically significant reduction in risk of breast cancer in BRCA1/2 mutation carriers (HR = 0.49; 95% confidence interval [CI] = 0.37 to 0.65). Similar risk reductions were observed in BRCA1 mutation carriers (HR = 0.47; 95% CI = 0.35 to 0.64) and in BRCA2 mutation carriers (HR = 0.47; 95% CI = 0.26 to 0.84). RRSO was also associated with a statistically significant reduction in the risk of BRCA1/2-associated ovarian or fallopian tube cancer (HR = 0.21; 95% CI = 0.12 to 0.39). Data were insufficient to obtain separate estimates for ovarian or fallopian tube cancer risk reduction with RRSO in BRCA1 or BRCA2 mutation carriers. The summary estimates presented here indicate that RRSO is strongly associated with reductions in the risk of breast, ovarian, and fallopian tube cancers and should provide guidance to women in planning cancer risk reduction strategies.

MeSH Terms
Breast Neoplasms/genetics,prevention & control Case-Control Studies Cohort Studies Fallopian Tubes/surgery Female Genes, BRCA1 Genes, BRCA2 Germ-Line Mutation Heterozygote Humans Odds Ratio Ovarian Neoplasms/genetics,prevention & control Ovariectomy Primary Prevention/methods Risk Assessment Risk Factors Risk Reduction Behavior
Authors & Affiliations
3 authors, click to expand affiliations / ORCID
Rebbeck Timothy R
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. rebbeck@mail.med.upenn.edu
Kauff Noah D
Domchek Susan M
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Article Info
Journal
Journal of the National Cancer Institute
Abbr.
J Natl Cancer Inst
ISSN
1460-2105
DOI
10.1093/jnci/djn442
Email
rebbeck@mail.med.upenn.edu
Published
2009-01-21
Epub
2009-00-13
Pages
80-7
Language
English
Region
United States
NLM ID
7503089
PMCID
PMC2639318
Subset
IM
Grants
NCI NIH HHS · R01-CA083855 · United States
NCI NIH HHS · R01-CA102776 · United States
Corrections
CommentIn
PMID: 19141782
External Links
PubMed source DOI: 10.1093/jnci/djn442 PMC Full Text View journal details
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