Bilateral Risk-Reduction Mastectomy in BRCA1 and BRCA2 Mutation Carriers: A Meta-analysis

Background Women with BRCA1 and BRCA2 mutations have substantially elevated risk of developing breast cancer. The aim of this study was to clarify the role of bilateral risk-reducing mastectomy (BRRM) in reducing breast cancer risk in women carriers of BRCA1 and BRCA2 mutations. Methods The Pubmed,...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-09, Vol.22 (9), p.2876-2880
Main Authors: De Felice, Francesca, Marchetti, Claudia, Musella, Angela, Palaia, Innocenza, Perniola, Giorgia, Musio, Daniela, Muzii, Ludovico, Tombolini, Vincenzo, Benedetti Panici, Pierluigi
Format: Article
Language:English
Subjects:
BRCA1 Protein - genetics
BRCA2 Protein - genetics
Breast Neoplasms - genetics
Breast Neoplasms - surgery
Breast Oncology
Female
Heterozygote
Humans
Mastectomy
Medicine
Medicine & Public Health
Mutation - genetics
Oncology
Prognosis
Prospective Studies
Risk Reduction Behavior
Surgery
Surgical Oncology
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Summary:Background Women with BRCA1 and BRCA2 mutations have substantially elevated risk of developing breast cancer. The aim of this study was to clarify the role of bilateral risk-reducing mastectomy (BRRM) in reducing breast cancer risk in women carriers of BRCA1 and BRCA2 mutations. Methods The Pubmed, MEDLINE and Scopus databases were searched to retrieve articles written in the English language. Two investigators independently extracted the characteristics and results of the selected studies. Only prospective trials with available absolute numbers of breast cancer and death events were included. Pooled hazard ratio (HR) with 95 % confidence interval (CI) was calculated using fixed or random effects model. Results Meta-analysis of four prospective studies, including 2635 patients, demonstrated a significant risk reduction of breast cancer incidence in BRCA1 and BRCA2 mutation carriers receiving BRRM (HR 0.07; 95 % CI 0.01–0.44; p  = 0.004). Among patients without previous risk-reducing salpingo-oophorectomy, a significant benefit was similarly recorded (HR 0.06; 95 % CI 0.01–0.41; p  = 0.005). Conclusions Performing BRRM may lead to highly significant risk reduction of breast cancer in BRCA1 and BRCA2 mutation carriers. These data allow clinicians to discuss more in-depth with patients all the available options in order to design better management strategies.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-015-4532-1