Rebbeck Timothy R, Friebel Tara, Wagner Theresa, Lynch Henry T, Garber Judy E, Daly Mary B, Isaacs Claudine, Olopade Olufunmilayo I, Neuhausen Susan L, van 't Veer Laura, Eeles Rosalind, Evans D Gareth, Tomlinson Gail, Matloff Ellen, Narod Steven A, Eisen Andrea, Domchek Susan, Armstrong Katrina, Weber Barbara L
Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania School of Medicine, Philadelphia, 19104, USA.
J Clin Oncol. 2005 Nov 1;23(31):7804-10. doi: 10.1200/JCO.2004.00.8151. Epub 2005 Oct 11.
Bilateral prophylactic oophorectomy (BPO) is widely used for cancer risk reduction in women with BRCA1/2 mutations. Many premenopausal women choose to take hormone replacement therapy (HRT) after undergoing BPO to abrogate immediate symptoms of surgically-induced menopause. Thus, we evaluated whether the breast cancer risk reduction conferred by BPO in BRCA1/2 mutation carriers is altered by use of post-BPO HRT.
We identified a prospective cohort of 462 women with disease-associated germline BRCA1/2 mutations at 13 medical centers to evaluate breast cancer risk after BPO with and without HRT. We determined the incidence of breast cancer in 155 women who had undergone BPO and in 307 women who had not undergone BPO on whom we had complete information on HRT use. Postoperative follow-up was 3.6 years.
Consistent with previous reports, BPO was significantly associated with breast cancer risk reduction overall (hazard ratio [HR] = 0.40; 95%CI, 0.18 to 0.92). Using mutation carriers without BPO or HRT as the referent group, HRT of any type after BPO did not significantly alter the reduction in breast cancer risk associated with BPO (HR = 0.37; 95% CI, 0.14 to 0.96).
Short-term HRT use does not negate the protective effect of BPO on subsequent breast cancer risk in BRCA1/2 mutation carriers.
双侧预防性卵巢切除术（BPO）被广泛用于降低携带BRCA1/2基因突变女性的癌症风险。许多绝经前女性在接受BPO后选择进行激素替代疗法（HRT），以消除手术导致的绝经的即时症状。因此，我们评估了BPO在BRCA1/2突变携带者中降低乳腺癌风险的作用是否会因BPO后使用HRT而改变。
我们在13个医疗中心确定了一个由462名患有与疾病相关的种系BRCA1/2突变的女性组成的前瞻性队列，以评估接受或未接受HRT的BPO后的乳腺癌风险。我们确定了155名接受BPO的女性和307名未接受BPO的女性的乳腺癌发病率，我们掌握了她们使用HRT的完整信息。术后随访时间为3.6年。
与之前的报告一致，BPO总体上与降低乳腺癌风险显著相关（风险比[HR]=0.40；95%可信区间，0.18至0.92）。以未接受BPO或HRT的突变携带者作为参照组，BPO后任何类型的HRT均未显著改变与BPO相关联的乳腺癌风险降低情况（HR=0.37；95%可信区间，0.14至0.96）。
短期使用HRT不会消除BPO对BRCA1/2突变携带者后续乳腺癌风险的保护作用。
