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Bilateral Oophorectomy Markedly Decreases Breast Cancer Risk.

Women with BRCA1 mutations who underwent bilateral prophylactic oophorectomies had a significantly decreased risk of developing breast cancer, compared with women with the mutation who did not have the procedure, reported Dr. Timothy R. Rebbeck of the University of Pennsylvania, Philadelphia, and his colleagues.

Among 122 women with BRCA1 mutations, 23% of the 43 who had oophorectomies developed breast cancer, compared with 38% of 79 women who did not have the surgery. After adjusting for the study participants' age at menarche, bilateral oophorectomy was associated with a hazard ratio of 0.53--a statisticaliy significant finding (J. Natl. Cancer Inst. 91 [17]: 1475-79, 1999).

Women in the surgery group were followed-up for an average of 9.6 years; controls were followed-up for an average of 8.1 years.

The use of hormone replacement therapy (HRT) did not appear to counteract the apparent protective effect of oophorectomy. However, this conclusion was based on very limited information about HRT use in all patients, the investigators said. Bilateral oophorectomy was associated with a hazard ratio of 0.42 among the 32 women who underwent surgery and were never exposed to HRT.

Although promising, the results are not enough to recommend prophylactic oophorectomy to women with BRCAI mutations, Dr. Kathy J. Helzlsouer of the Johns Hopkins School of Hygiene and Public Health, Baltimore, Md., said in an accompanying editorial (J. Natl. Cancer Inst. 91[17]:1442-43, 1999). The magnitude of risk reduction is similar to that seen in the Breast Cancer Prevention Trial among women on tamoxifen who had three or more first-degree relatives with breast cancer, she said.

In addition, the costs and benefits of the surgery, the effects of premature menopause, and the psychological effects of prophylactic surgery will have to be considered if future studies help solidify the link between exposure to ovarian hormones and breast cancer risk, the investigators said.
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Author:Arnold, Katherine
Publication:OB GYN News
Geographic Code:1USA
Date:Dec 1, 1999
Previous Article:Correction.
Next Article:Growing Up in the North May Increase Osteoporosis Risk.

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