Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers
| Autor: | Hans F. A. Vasen, Hanne Meijers-Heijboer, C. J. van Asperen, F.E. van Leeuwen, C. M. Kets, T. A. M. van Os, J. M. Collee, S. Verhoef, M. G. E. M. Ausems, Marian J.E. Mourits, E. B. Gomez Garcia, Matti A. Rookus, Maartje J. Hooning, Caroline Seynaeve, Bernadette A M Heemskerk-Gerritsen, H. C. van Doorn |
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| Přispěvatelé: | CCA -Cancer Center Amsterdam, ARD - Amsterdam Reproduction and Development, Human Genetics, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Targeted Gynaecologic Oncology (TARGON), Life Course Epidemiology (LCE), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Medical Oncology, Clinical Genetics, Obstetrics & Gynecology, Health promotion, Klinische Genetica, Psychiatrie & Neuropsychologie, Promovendi NTM, RS: GROW - Oncology, RS: GROW - R4 - Reproductive and Perinatal Medicine, Epidemiology and Data Science, Human genetics, CCA - Oncogenesis |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty PENETRANCE REDUCING SURGERY Research Support OVARIAN-CANCER PROPHYLACTIC OOPHORECTOMY Breast cancer SDG 3 - Good Health and Well-being Internal medicine MASTECTOMY medicine Journal Article Non-U.S. Gov't Gynecology business.industry Proportional hazards model Research Support Non-U.S. Gov't Hazard ratio WOMEN Odds ratio medicine.disease Penetrance Confidence interval BIAS CARCINOMAS SURVIVAL business Risk assessment FOLLOW-UP Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] Cohort study |
| Zdroj: | JNCI: Journal of the National Cancer Institute, 107(5) Journal of the National Cancer Institute, 107, 5, pp. pii: djv033-pii: djv033 Journal of the National Cancer Institute, 107(5). Oxford University Press Journal of the National Cancer Institute, 107(5):033. Oxford University Press Journal of the National Cancer Institute, 107(5):djv033. Oxford University Press Journal of the National Cancer Institute, 107, pii: djv033-pii: djv033 Heemskerk-Gerritsen, B A M, Seynaeve, C, van Asperen, C J, Ausems, M G E M, Collee, J M, van Doorn, H C, Garcia, E B G, Kets, C M, van Leeuwen, F E, Meijers-Heijboer, H E J, Mourits, M J E, van Os, T A M, Vasen, H F A, Verhoef, S, Rookus, M A & Hooning, M J 2015, ' Breast Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation Carriers: Revisiting the Evidence for Risk Reduction ', Journal of the National Cancer Institute, vol. 107, no. 5, djv033 . https://doi.org/10.1093/jnci/djv033 |
| ISSN: | 1460-2105 0027-8874 |
| DOI: | 10.1093/jnci/djv033 |
| Popis: | Item does not contain fulltext BACKGROUND: Previous studies have reported a breast cancer (BC) risk reduction of approximately 50% after risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers, but may have been subject to several types of bias. The purpose of this nationwide cohort study was to assess potential bias in the estimated BC risk reduction after RRSO. METHODS: We selected BRCA1/2 mutation carriers from an ongoing nationwide cohort study on Hereditary Breast and Ovarian Cancer in the Netherlands (HEBON). First, we replicated the analytical methods as previously applied in four major studies on BC risk after RRSO. Cox proportional hazards models were used to calculate hazard ratios and conditional logistic regression to calculate odds ratios. Secondly, we analyzed the data in a revised design in order to further minimize bias using an extended Cox model with RRSO as a time-dependent variable to calculate the hazard ratio. The most important differences between our approach and those of previous studies were the requirement of no history of cancer at the date of DNA diagnosis and the inclusion of person-time preceding RRSO. RESULTS: Applying the four previously described analytical methods and the data of 551 to 934 BRCA1/2 mutation carriers with a median follow-up of 2.7 to 4.6 years, the odds ratio was 0.61 (95% confidence interval [CI] = 0.35 to 1.08), and the hazard ratios were 0.36 (95% CI = 0.25 to 0.53), 0.62 (95% CI = 0.39 to 0.99), and 0.49 (95% CI = 0.33 to 0.71), being similar to earlier findings. For the revised analysis, we included 822 BRCA1/2 mutation carriers. After a median follow-up period of 3.2 years, we obtained a hazard ratio of 1.09 (95% CI = 0.67 to 1.77). CONCLUSION: In previous studies, BC risk reduction after RRSO in BRCA1/2 mutation carriers may have been overestimated because of bias. Using a design that maximally eliminated bias, we found no evidence for a protective effect. |
| Databáze: | OpenAIRE |
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