Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Rome, Italy.
Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
Crit Rev Oncol Hematol. 2018 Dec;132:111-115. doi: 10.1016/j.critrevonc.2018.09.018. Epub 2018 Oct 3.
Hormone replacement therapy (HRT) has been tested in women with BRCA1 and BRCA2 mutations who underwent risk-reducing salpingo-oophorectomy (RRSO), but its effect on breast cancer (BC) risk has never been appraised using meta-analysis comparison. We performed the first meta-analysis aimed to clarify whether HRT after RRSO could negatively impact on BC risk in women carriers of BRCA1 and BRCA2 mutations.
Pubmed and Scopus databases were searched to retrieve articles written in the English language. Trials comparing RRSO with or without HRT were identified and only those trials with available BC events were included. BC risk was the main endpoint.
Three trials with 1100 patients were included. There was not a significantly higher BC risk in BRCA1 and BRCA2 mutation carriers receiving HRT after RRSO (HR = 0.98; 95% CI 0.63-1.52). There was a slightly but not significantly, benefit in BC risk reduction in favor of estrogen alone HRT versus estrogen plus progesterone HRT formulation (OR = 0.53; 95% CI 0.25-1.15).
HRT use after RRSO in BRCA 1 and BRCA2 mutation carries does not affect BC risk. Comparison of the different HRT types suggests that estrogen alone should be related to lowest BC risk.
接受预防性输卵管卵巢切除术（RRSO）的 BRCA1 和 BRCA2 突变携带者已接受激素替代疗法（HRT）的测试，但从未使用荟萃分析比较来评估其对乳腺癌（BC）风险的影响。我们进行了首次旨在阐明 RRSO 后 HRT 是否会对 BRCA1 和 BRCA2 突变携带者的 BC 风险产生负面影响的荟萃分析。
检索 Pubmed 和 Scopus 数据库以检索用英文撰写的文章。确定了比较 RRSO 加或不加 HRT 的试验，并且仅纳入了具有可用 BC 事件的试验。BC 风险是主要终点。
纳入了三项涉及 1100 名患者的试验。RRSO 后接受 HRT 的 BRCA1 和 BRCA2 突变携带者的 BC 风险没有显着增加（HR=0.98；95%CI 0.63-1.52）。单独使用雌激素的 HRT 与雌孕激素联合 HRT 制剂相比，BC 风险降低略有但无统计学意义（OR=0.53；95%CI 0.25-1.15）。
RRSO 后 BRCA 1 和 BRCA2 突变携带者使用 HRT 不会影响 BC 风险。不同 HRT 类型的比较表明，单独使用雌激素应与最低的 BC 风险相关。
