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SABCS: Risk-Reducing Surgery Improves Outcomes in Young Breast Cancer Patients With BRCA Mutations

Findings show survival benefits for both risk-reducing mastectomy and salpingo-oophorectomy

By Lori Solomon HealthDay Reporter

MONDAY, Dec. 16, 2024 (HealthDay News) — Risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO) are both associated with significant improvements in outcomes among young BRCA carriers with breast cancer, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

Matteo Lambertini, M.D., Ph.D., from the University of Genova-IRCCS Policlinico San Martino Hospital in Genoa, Italy, and colleagues investigated the association between RRM and/or RRSO and survival outcomes among young BRCA carriers with breast cancer. The analysis included 5,292 women with germline BRCA1 and/or BRCA2 pathogenic variants diagnosed with stage I to III invasive breast cancer at 40 years of age or younger (2000 through 2020).

The researchers found that during a median follow-up of 8.2 years, RRM and RRSO were both associated with improved outcomes. Patients who underwent RRM had a 35 percent lower risk for death and a 42 percent lower risk for breast cancer recurrence or second primary malignancy, while those who underwent RRSO had a 42 percent lower risk for death and a 32 percent lower risk for breast cancer recurrence or second primary malignancy. For RRM, improved outcomes were seen whether or not the germline BRCA mutation was present in the BRCA1 or BRCA2 gene; however, for RRSO, overall survival varied, with a greater survival benefit seen for patients with germline mutations in BRCA1 than in BRCA2 (56 and 15 percent lower risk for death, respectively). For patients undergoing RRSO, the greatest survival benefits were seen for triple-negative and hormone receptor-positive breast cancers (56 and 20 percent lower risk for death, respectively). Among patients who underwent both surgeries and those who had only one surgery, overall survival was similar.

“These findings are critical for improving the counseling of young BRCA carriers with breast cancer on cancer risk management strategies,” the authors write.

One author disclosed ties to the pharmaceutical industry.


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