Oophorectomy is associated with a decrease in mortality in women with breast cancer and a BRCA1 mutation, and women with estrogen receptor-negative breast cancer and a BRCA1 mutation should undergo the procedure shortly after diagnosis, according to research published in JAMA Oncology.

Researchers followed 676 women who had early-stage breast cancers and were carriers of BRCA1 or BRCA2 mutations.

The women had received treatment for breast cancer, including mastectomy and lumpectomy. Roughly half had undergone an oophorectomy.


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Overall, 77.4 percent of women survived over the 20-year follow-up from time of diagnosis, the findings showed. In women who underwent oophorectomy, the adjusted hazard ratio for breast cancer-specific mortality was 0.38 (95 percent confidence [CI], 0.19 to 0.77; P = 0.007) for BRCA1 carriers and 0.57 (95 percent CI, 0.23 to 1.43; P = 0.23) for BRCA2 carriers.

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For women with estrogen receptor-positive breast cancer, the hazard ratio for breast cancer-specific mortality was 0.76 (95 percent CI, 0.32 to 1.78; P = 0.53), and for women with estrogen receptor-negative breast cancer, the hazard ratio was 0.07 (95 percent CI, 0.01 to 0.51; P = 0.009).

On average, oophorectomy was done six years after the breast cancer diagnosis, but earlier oophorectomy conferred a greater reduction in breast cancer death risk.

The protective effect of oophorectomy was especially strong if women had estrogen receptor-negative breast cancer after age 50.

Reference

  1. Metcalfe, Kelly, PhD, et al. “Effect of Oophorectomy on Survival After Breast Cancer in BRCA1 and BRCA2 Mutation Carriers.” JAMA Oncology. doi:10.1001/jamaoncol.2015.0658. [epub ahead of print]. April 23, 2015.