Anti-Cancer Effect of Salpingo-Oophorectomy Differs by BRCA Type

By Anthony J. Brown, MD

NEW YORK FEB 11, 2008 (Reuters Health) - Risk-reducing salpingo-oophorectomy (RRSO) can help prevent breast and gynecologic malignancies in high-risk women, but the benefit depends on the woman"s BRCA status, according to a report in the February 11th online issue of the Journal of Clinical Oncology.

The findings indicate that RRSO significantly reduces the odds of gynecologic cancer in BRCA1 carriers and the risk of breast cancer in BRCA2 carriers, lead author Dr. Noah D. Kauff, from Memorial Sloan-Kettering Cancer Center in New York, and his associates found.

Prior research has shown that RRSO lowers the risk of breast and gynecologic cancers in women with BRCA mutations. However, "all previous studies have either combined BRCA1 and BRCA2 mutation carriers together or evaluated BRCA1 mutation carriers alone," Dr. Kauff told Reuters Health.

"As many as 39% of all BRCA mutation carriers have a mutation in BRCA2 and these women may have very different responses to risk-reducing interventions than women with BRCA1 mutations."

The most important finding of the study, he said, "is that carriers of BRCA2 mutations appear to receive substantially greater protection against breast cancer from RRSO than carriers of BRCA1 mutations. As this issue has never been evaluated before, this is new information and surprising."

The study involved 1079 women who were at least 30 years of age and had a BRCA1 or BRCA2 mutation. The women were recruited between November 1, 1994 and December 1, 2004 at 1 of 11 centers and were followed through November 30, 2005. In all cases, the decision to undergo RRSO or observation was made by the patient.

During a 3-year follow-up period, RRSO significantly reduced the risks of BRCA1-associated gynecologic cancers and BRCA2-associated breast cancer by 85% and 72%, respectively. The surgery was also associated with reduced risks of BRCA2-associated gynecologic cancer and BRCA1-associated breast cancer, but these results did not reach statistical significance.

"These findings should help women with BRCA mutations and their doctors make more informed choices about strategies to reduce their risk of breast and gynecologic cancers," Dr. Kauff said.

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