Removal of the ovaries, a procedure known as an oophorectomy, was associated with a 62 percent reduction in breast cancer death in women diagnosed with breast cancer and carrying a BRCA1 gene mutation, according to an article authored by Bloomberg Nursing Professor Kelly Metcalfe, co-authored with Dr. Steven Narod at Women’s College Hospital, and published online by JAMA Oncology.
Women who carry a mutation in either the BRCA1 or BRCA2 gene face a lifetime risk of breast cancer of up to 70 percent. Once they are diagnosed with breast cancer, they face high risks of both second primary breast and ovarian cancers. Other studies of BRCA gene mutation carriers have reported reduced mortality associated with oophorectomy for women with a history of breast cancer, according to the study background.
The study found 20-year survival for the entire group was 77.4 percent. In the entire group, there was a 56 percent reduction in breast cancer death associated with oophorectomy. Undergoing an oophorectomy was associated with a significant reduction (62 percent) in breast cancer death in women with a BRCA1 mutation but not in women with a BRCA2 mutation because the 43 percent reduction authors found was not statistically significant.
According to the study results, oophorectomies were performed an average of six years after breast cancer diagnosis. For the 70 BRCA1 carriers for whom the oophorectomy was performed within two years of breast cancer diagnosis, there was a 73 percent reduction in death compared with women with a BRCA1 mutation who never underwent oophorectomy. The authors note the protective effect of oophorectomy on deaths from breast cancer was apparent immediately after diagnosis and lasted for 15 years.
“It is important that follow-up studies be performed on women who undergo oophorectomy as part of their initial treatment, in particular, those women who undergo oophorectomy in the first year after diagnosis. It is also important that our observations be confirmed in other study populations. Further data are needed, in particular for BRCA2 carriers in order to confirm the benefit of oophorectomy in this population,” article concludes.
Professor Metcalfe spoke to several media outlets to discuss the study, it’s outcomes, and how this procedure reduces the risk of breast cancer in women diagnosed with breast cancer and carrying the BRCA1 mutation.
Toronto study lends support to Angelina Jolie’s decision to remove ovaries (The Toronto Star)
with files from JAMA Oncology.