@article{ead8504316b8496fb89d2e2dacf89457,
title = "Bilateral prophylactic oophorectomy and bilateral prophylactic mastectomy in a prospective cohort of unaffected BRCA1 and BRCA2 mutation carriers",
abstract = "Background: Women with BRCA1 or BRCA2 (BRCA1/2) mutations can reduce cancer incidence and mortality by using bilateral prophylactic oophorectomy (BPO) or bilateral prophylactic mastectomy (BPM). The availability of these risk-reduction strategies is an important consideration in the decision to undergo genetic testing. Patients and Methods: We evaluated the use of BPO and BPM in a prospective sample of 537 female BRCA1/2 mutation carriers from 17 centers in North America and Europe. These women were aged > 30 years, had no BPM, BPO, breast cancer, or ovarian cancer before the disclosure of their genetic test results and were followed for ≥ 6 months. Results: Bilateral prophylactic oophorectomy is used significantly more frequently than BPM (55% vs. 21%; P < .001). Bilateral prophylactic oophorectomy was more common among women age ≥ 40 years compared with women aged < 40 years (68% vs. 43%; P < .001) and among parous women compared with nulliparous women (60% vs. 39%; P < .001). There was no difference in BPM (P = .83) or BPO (P = .09) in BRCA1 versus BRCA2 carriers. Multivariate models identified age and parity as a predictor of BPO in BRCA1 carriers; age and ovarian cancer family history in BRCA2 carriers; parity and ovarian cancer family history as a predictor of BPM in BRCA1 carriers; and smoking and ovarian cancer family history in BRCA2 carriers. Conclusion: Bilateral prophylactic oophorectomy is more commonly used than BPM in unaffected BRCA1/2 mutation carriers. Parity, age, and family history can also influence BPO and BPM uptake. Consistent with current recommendations, BPO is used by the majority of parous women aged > 40 years.",
keywords = "Genetic testing, Hereditary breast cancer, Surgery",
author = "Friebel, {Tara M.} and Domchek, {Susan M.} and Neuhausen, {Susan L.} and Theresa Wagner and Evans, {D. Gareth} and Claudine Isaacs and Garber, {Judy E.} and Daly, {Mary B.} and Rosalind Eeles and Ellen Matloff and Gail Tomlinson and Lynch, {Henry T.} and Nadine Tung and Blum, {Joanne L.} and Jeffrey Weitzel and Rubinstein, {Wendy S.} and Ganz, {Patricia A.} and Fergus Couch and Rebbeck, {Timothy R.}",
note = "Funding Information: The PROSE Consortium includes the following centers and individuals: Baylor-Charles A. Sammons Cancer Center (Joanne L. Blum, MD, PhD; Becky Althaus, RN, CGC; Gaby Ethington); Baylor College of Medicine (Claire Noll; Sharon Plon, MD, PhD); Beth Israel Deaconess Medical Center (Nadine Tung, MD); City of Hope National Medical Center (Veronica Lagos; Jeffrey Weitzel, MD); Creighton University (Carrie Snyder, BA; Henry T. Lynch, MD; Patrice Watson, PhD); Dana-Farber Cancer Institute (Jamie Elkins; Kathryn Stoeckert; Judy E. Garber, MD, MPH); Duke University (Sydnee Crankshaw; Joellen Schildkraut, PhD); Evanston Northwestern Healthcare Center for Medical Genetics (Suzanne M. O{\textquoteright}Neill, CGC; Anna Newlin, CGC; Wendy S. Rubinstein, MD); Fox Chase Cancer Center (Mary B. Daly, MD, PhD); Georgetown University (Camille Jasper; Claudine Isaacs, MD); Jonsson Comprehensive Cancer Center at the University of California, Los Angeles (Joyce Seldon; Patricia A. Ganz, MD); Mayo Clinic College of Medicine (Linda Wadum; Fergus Couch, PhD); Netherlands Cancer Institute (Marc van Beurden MD, PhD; Laura van{\textquoteright}t Veer, PhD); Royal Marsden Hospital (Rosalind Eeles, MD; Elizabeth Bancroft); St. Mary{\textquoteright}s Hospital (Gareth Evans, MD; Andrew Shenton); University of Chicago (Shelly Cummings; Olufunmilayo Olopade, MD); University of California, Irvine (Susan L. Neuhausen, PhD; Linda Steele); University of Pennsylvania (Susan Domchek, MD; K. Nathanson, MD; Tara M. Friebel, MPH; Timothy Rebbeck, PhD); University of Texas Southwestern Medical Center (Gail Tomlinson, MD); University of Vienna (Theresa Wagner, PhD); Women{\textquoteright}s College Hospital (Steven A. Narod, MD); Yale University (Ellen Matloff, MS). This publication was supported in part by revenue from Nebraska cigarette taxes awarded to Creighton University by the Nebraska Department of Health and Human Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the State of Nebraska or the Nebraska Department of Health and Human Services. Support was also received from National Institutes of Health grants 5UO1 CA86389 (to Henry T. Lynch) and R01-CA083855, R01-CA74415 (to Susan L. Neuhausen) and R01-CA102776 (to Timothy R. Rebbeck).",
year = "2007",
month = dec,
doi = "10.3816/CBC.2007.n.053",
language = "English (US)",
volume = "7",
pages = "875--882",
journal = "Clinical Breast Cancer",
issn = "1526-8209",
publisher = "Elsevier",
number = "11",
}