Ovurate and fallopian tube removal in connection with a lower risk of death in BRCA carriers with breast cancer

Women who were diagnosed with breast cancer that have certain BRCA1 and BRCA2 genetic variants are operated on to remove the ovaries and fallopian tubes, as this dramatically reduces their risk of ovarian cancer.

Now the researchers of Cambridge have shown that this procedure, which is known as a bilateral salpingo-oophorectomy (BSO)-is associated with a significant reduction in the risk of early death in these women without serious side effects.

Women with certain variants of the Gene BRCA1 and BRCA2 have a high risk of developing ovarian and breast cancer. These women are recommended to remove their ovaries and fallopian tubes at a relatively early age -between 35 and 40 years for BRCA1 carriers and between 40 and 45 years for BRCA2 carriers.

Previously, it was shown that BSO leads to 80% reduction in the risk of developing ovarian cancer in these women. However, there is a concern that due to the main source of the estrogen that brings the early menopause, it can have unintentional consequences. This can be particularly difficult for BRCA1 and BRCA2 with breast cancer history, since they may not receive the hormone replacement therapy for the treatment of symptoms. The overall effect of BSO in BRCA1 and BRCA2 carriers with a history of breast cancer remains uncertain.

Usually the researchers would evaluate the advantages and risks associated with BSO by randomized controlled studies, with the “gold standard” being tested how well treatments work. However, this would be unethical in women who carry the BRCA1 and BRCA2 variants, since they would expose them to a much higher risk of developing ovarian cancer.

In order to avoid this problem, a team at the University of Cambridge in cooperation with the National Disease Registration Service (NDRS) in NHS England in electronic health files and data from NHS gentest laboratories, which were collected and curated by NDRS, was curated by the long-term results of BSO and To examine BRCA2-PV-BRCA2-BRCA2-BRCA2-PV-BRCA-BRCA-BRCA. The results of her study, the first large -scale study of this kind, are published today in The Lancet -Oncology.

The team identified a total of 3,400 women with one of the BRCA1 and BRCA2 cancer variants (around 1,700 women for each variant). Around 850 of the BRCA1 carriers and 1,000 of the BRCA2 carriers had subjected a BSO operation.

Women who were subjected to BSO die during the follow -up period (a medium after -observation period of 5.5 years). This reduction was more pronounced in BRCA2 carriers compared to BRCA1 carriers (a reduction of 56% compared to 38%). These women also had around 40% lower risk of raising a second cancer.

Although the team says it is impossible to say with 100% certainty that BSO causes this risk reduction, they argue that the evidence indicates this conclusion.

It is important that the researchers have no connection between BSO and increased risk of other long -term results such as heart disease and stroke or with depression. This is in contrast to previous studies that have determined information in the general population of a connection between BSO and an increased risk of these conditions.

The first author Hend Hassan, a doctoral student of the Center for Cancer Genetic Epidemiology, Department of Public Health and Ground Supply, and the Wolfson College, Cambridge, said: “We know that removing the ovaries and fallopian tubes dramatically reduces the risk of ovarian cancer, but it is a question that the potential consequences are suddenly could have from the sudden acquisition of deserts.

“Soothingly, our research has shown that this procedure for women with personal breast cancer history brings clear advantages with regard to survival and a low risk of other types of cancer without negative side effects such as heart disease or depression.”

Most women who were subjected to BSO were white. Black and Asian women were also BSO, compared to white women. Women who lived in less disadvantaged areas were more likely to have BSO than in the category of the most coated categories.

Hassan added: “In view of the clear advantages that this procedure offers for endangered women, it is able that some groups of women are less likely. We have to understand why this is the case and to promote the admission of these women.”

Our results are crucial for the advice of women with cancer associated with one of the BRCA1 and BRCA2 variants so that you can make well -founded decisions about whether you choose this operation or not. “

Professor Antonis Antoniou, senior author of the study, Ministry of Public Health and Ground Supply

Professor Antoniou, who is also director of the data-controlled cancer program, added: “The study also shows the performance of exceptional NHS records in promoting effective, clinically relevant research.”

Research was financed by Cancer Research UK with additional support from the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Center.