Bone health after RRBSO among BRCA1/2 mutation carriers: a population-based study.

Autor:	do Valle HA; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, University of British Columbia, Vancouver, BC, Canada., Kaur P; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, University of British Columbia, Vancouver, BC, Canada., Kwon JS; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, University of British Columbia, Vancouver, BC, Canada., Cheifetz R; Department of Surgery, University of British Columbia, Vancouver, BC, Canada.; High-Risk Clinic, Hereditary Cancer Program, BC Cancer Agency, Vancouver, BC, Canada., Dawson L; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, University of British Columbia, Vancouver, BC, Canada.; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, Memorial University of Newfoundland, St. John's, NL, Canada., Hanley GE; Division of Gynaecologic Oncology, Department of Gynaecology and Obstetrics, University of British Columbia, Vancouver, BC, Canada. Gillian.hanley@vch.ca.
Jazyk:	angličtina
Zdroj:	Journal of gynecologic oncology [J Gynecol Oncol] 2022 Jul; Vol. 33 (4), pp. e51. Date of Electronic Publication: 2022 Mar 30.
DOI:	10.3802/jgo.2022.33.e51
Abstrakt:	Objective: Examine the risks of fractures and osteoporosis after risk-reducing bilateral salpingo-oophorectomy (RRBSO) among women with BRCA1/2 mutations. Methods: In this retrospective population-based study in British Columbia, Canada, between 1996 to 2017, we compared risks of osteoporosis and fractures among women with BRCA1/2 mutations who underwent RRBSO before the age of 50 (n=329) with two age-matched groups without known mutations: 1) women who underwent bilateral oophorectomy (BO) (n=3,290); 2) women with intact ovaries who had hysterectomy or salpingectomy (n=3,290). Secondary outcomes were: having dual-energy X-ray absorptiometry (DEXA) scan, and bisphosphonates use. Results: The mean age at RRBSO was 42.4 years (range, 26-49) and the median follow-up for women with BRCA1/2 mutations was 6.9 years (range, 1.1-19.9). There was no increased hazard of fractures for women with BRCA1/2 mutations (adjusted hazard ratio [aHR]=0.80; 95% confidence interval [CI]=0.56-1.14 compared to women who had BO; aHR=1.02; 95% CI=0.65-1.61 compared to women with intact ovaries). Among women who had DEXA-scan, those with BRCA1/2 mutations had higher risk of osteoporosis (aHR=1.60; 95% CI=1.00-2.54 compared to women who had BO; aHR=2.49; 95% CI=1.44-4.28 compared to women with intact ovaries). Women with BRCA1/2 mutations were more likely to get DEXA-scan than either control groups, but only 46% of them were screened. Of the women with BRCA1/2 mutations diagnosed with osteoporosis, 36% received bisphosphonates. Conclusion: Women with BRCA1/2 mutations had higher risk of osteoporosis after RRBSO, but were not at increased risk of fractures during our follow-up. Low rates of DEXA-scan and bisphosphonates use indicate we can improve prevention of bone loss. Competing Interests: Dr. Dawson reports grants from Astra Zeneca Canada, grants from LiquidThermDX, personal fees from Preventum Health, outside the submitted work. Dr. Kwon discloses research funding from Astra Zeneca Canada, and participation in an advisory board for Astra Zeneca Canada. No other potential conflict of interest relevant to this article was reported. (Copyright © 2022. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
Databáze:	MEDLINE
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