Risk‐reducing salpingo‐oophorectomy and breast cancer incidence among Jewish BRCA1/BRCA2‐mutation carriers—an Israeli matched‐pair study

Objective

To study the association of risk‐reducing bilateral salpingo‐oophorectomy (RRBSO) and breast cancer risk among BRCA pathogenic sequence variants (PSV).

Methods

Jewish Israeli BRCA carriers who underwent RRBSO were matched with those who did not—by the mutated gene and year of birth (±1 year). Breast cancer rates were compared.

Results

Overall, 127 pairs met the inclusion criteria, 79 (60.6%) pairs harbored BRCA1 PSV and 50 (39.4%) pairs harbored BRCA2 PSV. Median follow up was 8.7 years (interquartile range 4.6–16.1 years). Breast cancer rate for all BRCA carriers combined was not affected by RRBSO (RRBSO 21 [16.5%] versus no RRBSO 31 [24.4%], hazard ratio [HR] for breast cancer 0.61, 95% confidence interval [CI] 0.33–1.14, P = 0.127). No association between RRBSO and breast cancer incidence was noted among BRCA1 PSV carriers. In BRCA2 PSV carriers, RRBSO was associated with a decreased overall breast cancer incidence (HR 0.20, 95% CI 0.44–0.91, P = 0.038), as well as after 5, 10, 15, and 20 years. Hormone replacement therapy was used by 62 PSV carriers, 52 in the RRBSO group and 10 in the no‐RRBSO group and did not affect breast cancer risk (P = 0.463).

Conclusion

RRBSO is associated with breast cancer risk reduction in Jewish Israeli BRCA2 PSV carriers.

Risk‐reducing bilateral salpingo‐oophorectomy was associated with breast cancer risk reduction in Jewish Israeli BRCA2 pathogenic sequence variant carriers.