Surgery can lower cancer risk in high-risk brca1/2 carriers

Removal of the ovaries and fallopian tubes, a surgical procedure referred to as salpingo-oophorectomy, in women who carry the BRCA1 or BRCA2 gene mutation, can lower their risk of breast cancer by about 50 percent and their risk of ovarian or fallopian tube cancer by roughly 80 percent, suggest the results of a review of 10 published studies.

Prior research has shown that this procedure can help prevent breast, ovarian, and fallopian tube malignancies in these high-risk patients, but the magnitude of the risk reduction was unclear, lead author Dr. Timothy R. Rebbeck, from the University of Pennsylvania School of Medicine and colleagues explain.

To investigate, the research team searched PubMed, a large medical database, for studies that examined breast or gynecologic cancer outcomes in BRCA mutation carriers who underwent salpingo-oophorectomy. Data from 10 studies were included in the review, also referred to as a meta-analysis.

The investigators report their findings in the Journal of the National Cancer Institute for January 21, 2009.

Salpingo-oophorectomy reduced the risk of breast cancer in BRCA1 and BRCA2 mutation carriers by 53 percent, the report indicates. Likewise, the operation was associated with a 79 percent reduced risk of BRCA1/2-related ovarian or fallopian tube cancer.

Despite the efficacy of this surgery in BRCA1/2 mutation carriers, the authors note that a residual cancer risk still remains. As such, other cancer risk reduction and screening approaches are still needed to fully reduce cancer rates and mortality in these high-risk patients.

In an accompanying editorial, Dr. Mark H. Greene and Dr. Phuong L. Mai, from the National Cancer Institute in Rockville, Maryland, comment that Dr. Rebbeck’s team has “provided us with a meticulously executed, up-to-date meta-analysis that quantifies the reductions in the risks of breast and ovarian/fallopian tube cancer that follow salpingo-oophorectomy in BRCA1/2 mutation carriers.”

SOURCE: Journal of the National Cancer Institute, January 21, 2009.

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