Bilateral Salpingo-oophorectomy and Breast Cancer Risk for BRCA1 and BRCA2 Mutation Carriers: Assessing the Evidence

Conduit, C; Milne, RL; Friedlander, ML; Phillips, KA

Author(s): Conduit, C; Milne, RL; Friedlander, ML; Phillips, KA;
Details: Publication Year 2021-11,Volume 14,Issue #11,Page 983-993
Journal Title: Cancer Prevention Research
Publication Type: Review
Abstract: Without preventive interventions, women with germline pathogenic variants in BRCA1 or BRCA2 have high lifetime risks for breast cancer and tubo-ovarian cancer. The increased risk for breast cancer starts at a considerably younger age than that for tubo-ovarian cancer. Risk-reducing bilateral salpingo-oophorectomy (rrBSO) is effective in reducing tubo-ovarian cancer risk for BRCA1 and BRCA2 mutation carriers, but whether it reduces breast cancer risk is less clear. All studies of rrBSO and breast cancer risk are observational in nature and subject to various forms of bias and confounding, thus limiting conclusions that can be drawn about causation. Early studies supported a statistically significant protective association for rrBSO on breast cancer risk, which is reflected by several international guidelines that recommend consideration of premenopausal rrBSO for breast cancer risk reduction. However, these historical studies were hampered by the presence of several important biases, including immortal person-time bias, confounding by indication, informative censoring, and confounding by other risk factors, which may have led to overestimation of any protective benefit. Contemporary studies, specifically designed to reduce some of these biases, have yielded contradictory results. Taken together, there is no clear and consistent evidence for a role of premenopausal rrBSO in reducing breast cancer risk in BRCA1 or BRCA2 mutation carriers.
Keywords: BRCA1 Protein/genetics; BRCA2 Protein/genetics; *Breast Neoplasms/genetics/prevention & control; Female; Genetic Predisposition to Disease; Humans; Mutation; *Ovarian Neoplasms/genetics/prevention & control; Ovariectomy; Risk; Salpingo-oophorectomy/methods
Department(s): Medical Oncology
PubMed ID: 34348913
Publisher's Version: https://doi.org/10.1158/1940-6207.CAPR-21-0141
Open Access at Publisher's Site: https://doi.org/10.1158/1940-6207.CAPR-21-0141
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-08-29 05:47:54

Last Modified: 2025-08-29 05:53:29