RISK-REDUCING surgeries, including bilateral mastectomy (RRM) and salpingo-oophorectomy (RRSO), are associated with improved survival outcomes in BRCA-mutation carriers diagnosed with breast cancer at or before age 40, according to a study presented at the 2024 San Antonio Breast Cancer Symposium (SABCS).
The global study, led by Dr. Matteo Lambertini from the University of Genoa, analyzed data from 5,290 patients diagnosed with early-onset breast cancer who carried germline BRCA1 or BRCA2 mutations. Among the cohort, 3,888 underwent at least one risk-reducing procedure, with 2,910 patients receiving RRM, 2,782 undergoing RRSO, and 1,804 opting for both surgeries.
Results showed that patients who underwent RRM had a 35% lower risk of death and a 42% reduction in the risk of breast cancer recurrence or secondary malignancies. Those who underwent RRSO experienced a 42% lower risk of death and a 32% reduction in recurrence or second cancers, with particularly significant survival benefits in patients with triple-negative breast cancer.
The study emphasized that RRSO had a more pronounced effect on survival for BRCA1 mutation carriers (56% reduced risk of death) compared to those with BRCA2 mutations (15% reduced risk). The findings underscore the importance of incorporating risk-reducing surgeries into cancer-risk management for BRCA-mutation carriers with early-onset breast cancer.
Lambertini highlighted the critical need for healthcare providers to weigh the benefits and risks of these procedures, as they can lead to infertility and early menopause—issues that must be carefully considered for younger patients.
This analysis, from the international BRCA BCY Collaboration study, provides the first evidence supporting the long-term survival advantages of risk-reducing surgeries for this patient group, helping guide future treatment decisions and counseling.
Reference: San Antonio Breast Cancer Symposium. (2024, December 11). PARP Inhibition Shows Long-term Survival Benefits for Patients With High-risk, BRCA-positive Breast Cancer in OlympiA Trial. Presented at SABCS 2024.
Anaya Malik | AMJ
