Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis
Background: Risk-reducing salpingo-oophorectomy (RRSO) is the gold standard method of ovarian cancer risk reduction, but the data are conflicting regarding the impact on breast cancer (BC) outcomes. This study aimed to quantify BC risk/mortality in <i>BRCA1</i>/<i>BRCA2</i> c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/5/1625 |
| _version_ | 1797615610984660992 |
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| author | Faiza Gaba Oleg Blyuss Alex Tan Daniel Munblit Samuel Oxley Khalid Khan Rosa Legood Ranjit Manchanda |
| author_facet | Faiza Gaba Oleg Blyuss Alex Tan Daniel Munblit Samuel Oxley Khalid Khan Rosa Legood Ranjit Manchanda |
| author_sort | Faiza Gaba |
| collection | DOAJ |
| description | Background: Risk-reducing salpingo-oophorectomy (RRSO) is the gold standard method of ovarian cancer risk reduction, but the data are conflicting regarding the impact on breast cancer (BC) outcomes. This study aimed to quantify BC risk/mortality in <i>BRCA1</i>/<i>BRCA2</i> carriers after RRSO. Methods: We conducted a systematic review (CRD42018077613) of <i>BRCA1</i>/<i>BRCA2</i> carriers undergoing RRSO, with the outcomes including primary BC (PBC), contralateral BC (CBC) and BC-specific mortality (BCSM) using a fixed-effects meta-analysis, with subgroup analyses stratified by mutation and menopause status. Results: RRSO was not associated with a significant reduction in the PBC risk (RR = 0.84, 95%CI: 0.59–1.21) or CBC risk (RR = 0.95, 95%CI: 0.65–1.39) in <i>BRCA1</i> and <i>BRCA2</i> carriers combined but was associated with reduced BC-specific mortality in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined (RR = 0.26, 95%CI: 0.18–0.39). Subgroup analyses showed that RRSO was not associated with a reduction in the PBC risk (RR = 0.89, 95%CI: 0.68–1.17) or CBC risk (RR = 0.85, 95%CI: 0.59–1.24) in <i>BRCA1</i> carriers nor a reduction in the CBC risk in <i>BRCA2</i> carriers (RR = 0.35, 95%CI: 0.07–1.74) but was associated with a reduction in the PBC risk in <i>BRCA2</i> carriers (RR = 0.63, 95%CI: 0.41–0.97) and BCSM in BC-affected <i>BRCA1</i> carriers (RR = 0.46, 95%CI: 0.30–0.70). The mean NNT = 20.6 RRSOs to prevent one PBC death in <i>BRCA2</i> carriers, while 5.6 and 14.2 RRSOs may prevent one BC death in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined and <i>BRCA1</i> carriers, respectively. Conclusions: RRSO was not associated with PBC or CBC risk reduction in <i>BRCA1</i> and <i>BRCA2</i> carriers combined but was associated with improved BC survival in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined and <i>BRCA1</i> carriers and a reduced PBC risk in <i>BRCA2</i> carriers. |
| first_indexed | 2024-03-11T07:29:08Z |
| format | Article |
| id | doaj.art-c5ed807e6a4d42a89e6d6b9b7052451a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T07:29:08Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c5ed807e6a4d42a89e6d6b9b7052451a2023-11-17T07:26:36ZengMDPI AGCancers2072-66942023-03-01155162510.3390/cancers15051625Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-AnalysisFaiza Gaba0Oleg Blyuss1Alex Tan2Daniel Munblit3Samuel Oxley4Khalid Khan5Rosa Legood6Ranjit Manchanda7Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB24 3FX, UKWolfson Institute of Population Health, Barts CRUK Cancer Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UKWolfson Institute of Population Health, Barts CRUK Cancer Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UKDepartment of Paediatrics and Paediatric Infectious Diseases, Institute of Child’s Health, Sechenov First Moscow State Medical University (Sechenov University), 29 Shmitovskiy Proezd, 123337 Moscow, RussiaDepartment of Gynaecological Oncology, Barts Health NHS Trust, London E1 1FR, UKDepartment of Preventive Medicine and Public Health, Universidad de Granada, 18071 Granada, SpainDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UKDepartment of Gynaecological Oncology, Barts Health NHS Trust, London E1 1FR, UKBackground: Risk-reducing salpingo-oophorectomy (RRSO) is the gold standard method of ovarian cancer risk reduction, but the data are conflicting regarding the impact on breast cancer (BC) outcomes. This study aimed to quantify BC risk/mortality in <i>BRCA1</i>/<i>BRCA2</i> carriers after RRSO. Methods: We conducted a systematic review (CRD42018077613) of <i>BRCA1</i>/<i>BRCA2</i> carriers undergoing RRSO, with the outcomes including primary BC (PBC), contralateral BC (CBC) and BC-specific mortality (BCSM) using a fixed-effects meta-analysis, with subgroup analyses stratified by mutation and menopause status. Results: RRSO was not associated with a significant reduction in the PBC risk (RR = 0.84, 95%CI: 0.59–1.21) or CBC risk (RR = 0.95, 95%CI: 0.65–1.39) in <i>BRCA1</i> and <i>BRCA2</i> carriers combined but was associated with reduced BC-specific mortality in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined (RR = 0.26, 95%CI: 0.18–0.39). Subgroup analyses showed that RRSO was not associated with a reduction in the PBC risk (RR = 0.89, 95%CI: 0.68–1.17) or CBC risk (RR = 0.85, 95%CI: 0.59–1.24) in <i>BRCA1</i> carriers nor a reduction in the CBC risk in <i>BRCA2</i> carriers (RR = 0.35, 95%CI: 0.07–1.74) but was associated with a reduction in the PBC risk in <i>BRCA2</i> carriers (RR = 0.63, 95%CI: 0.41–0.97) and BCSM in BC-affected <i>BRCA1</i> carriers (RR = 0.46, 95%CI: 0.30–0.70). The mean NNT = 20.6 RRSOs to prevent one PBC death in <i>BRCA2</i> carriers, while 5.6 and 14.2 RRSOs may prevent one BC death in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined and <i>BRCA1</i> carriers, respectively. Conclusions: RRSO was not associated with PBC or CBC risk reduction in <i>BRCA1</i> and <i>BRCA2</i> carriers combined but was associated with improved BC survival in BC-affected <i>BRCA1</i> and <i>BRCA2</i> carriers combined and <i>BRCA1</i> carriers and a reduced PBC risk in <i>BRCA2</i> carriers.https://www.mdpi.com/2072-6694/15/5/1625<i>BRCA</i>risk-reducing salpingo-oophorectomybreast cancermeta-analysis |
| spellingShingle | Faiza Gaba Oleg Blyuss Alex Tan Daniel Munblit Samuel Oxley Khalid Khan Rosa Legood Ranjit Manchanda Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis Cancers <i>BRCA</i> risk-reducing salpingo-oophorectomy breast cancer meta-analysis |
| title | Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis |
| title_full | Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis |
| title_fullStr | Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis |
| title_short | Breast Cancer Risk and Breast-Cancer-Specific Mortality following Risk-Reducing Salpingo-Oophorectomy in <i>BRCA</i> Carriers: A Systematic Review and Meta-Analysis |
| title_sort | breast cancer risk and breast cancer specific mortality following risk reducing salpingo oophorectomy in i brca i carriers a systematic review and meta analysis |
| topic | <i>BRCA</i> risk-reducing salpingo-oophorectomy breast cancer meta-analysis |
| url | https://www.mdpi.com/2072-6694/15/5/1625 |
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