This article is more than 5 years old. Information may no longer be current.

Survival estimates may help patients with BRCA mutations choose best risk reduction strategy

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Prophylactic mastectomy when aged 25 years plus prophylactic oophorectomy when aged 40 years may be the most effective risk reduction strategy for women with BRCA mutations; however, substituting mammography plus MRI screening for prophylactic mastectomy appeared to offer comparable survival outcomes, according to data from a simulation model.

“The results of this study have the potential to markedly facilitate decision making as women can be provided with BRCA mutation-specific data on the effects of different risk management strategies, undertaken at varying ages, on OS as well as on survival from breast and gynecologic cancer,” Zsofia K. Stadler, MD, and Noah D. Kauff, MD, both of the Memorial Sloan-Kettering Cancer Center, wrote in an accompanying editorial.

Findings from previous studies examining the relationship between BRCA 1/2 mutations with surgery vs. screening were limited, according to researchers. Therefore, they developed a Monte Carlo model that simulated the life histories of 1 million women born in 1980 who were carriers of BRCA1 or BRCA2 mutations from age 25 years until aged 100 years or death.

When aged 70 years, survival with no intervention was 53% for those women with BRCA 1 mutations. The most effective single intervention was oophorectomy when aged 40 years, for which survival was 68% when aged 70 years, yielding an absolute gain of 15%.

When aged 70 years, survival with no intervention was 71% for those with BRCA2 mutations. The most effective single intervention was mastectomy when aged 25 years, yielding a gain of 8% vs. no intervention.

Among carriers of the BRCA1/2 mutations, the most effective combination strategy was prophylactic mastectomy when aged 25 years plus prophylactic oophorectomy when aged 40 years, yielding a 26% survival increase when aged 70 years for BRCA1 mutation carriers and an increase of 12% for BRCA2 mutation carriers.

Kurian AW. J Clin Oncol. 2009;doi:10.1200/JCO.2009.22.7991.

More In the Journals summaries>>