Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, China.
Eur J Surg Oncol. 2022 Jun;48(6):1209-1216. doi: 10.1016/j.ejso.2022.02.019. Epub 2022 Feb 18.
BRCA mutation carriers have a high lifetime risk of developing breast cancer (BC) and ovarian cancer (OC). Risk-reducing salpingo-oophorectomy (RRSO) has been shown to reduce OC risk. This meta-analysis was aim to analyze the effect of RRSO on the BC risk among BRCA1/2 mutation carriers.
Embase, PubMed, Web of Science, and Cochrane databases were searched for all studies investigating the effect of RRSO on BC risk. The pooled results were used to evaluate the association between RRSO and BC risk.
This meta-analysis included 13,965 BRCA1 and 7,057 BRCA2 mutation carriers from 14 observational studies. The pooled results showed that RRSO lowered BC risk among BRCA1 mutation carriers [hazard ratio (HR) = 0.63, 95% confidence interval (CI): 0.49-0.81, P < 0.01] and BRCA2 mutation carriers (HR = 0.51, 95% CI: 0.34-0.75, P < 0.01). RRSO reduced BC risk in younger women with BRCA1 mutation (HR = 0.48, 95% CI: 0.30-0.77, P < 0.01) and BRCA2 mutation (HR = 0.22, 95% CI: 0.08-0.65, P < 0.01). Analysis of the efficacy of RRSO at different time intervals after surgery showed a reduction of BC risk at <5 years after surgery in BRCA1 mutation carriers (HR = 0.60, 95% CI: 0.40-0.89, P = 0.01) and BRCA2 mutation carriers (HR = 0.42, 95% CI: 0.20-0.86, P = 0.02).
RRSO is an effective way to reduce BC risk among women with BRCA1/2 mutation, especially in younger women. BRCA1/2 mutation carriers could benefit from RRSO in the immediate 5 years after surgery.
BRCA 基因突变携带者终生患乳腺癌（BC）和卵巢癌（OC）的风险较高。已经证明，降低风险的输卵管卵巢切除术（RRSO）可以降低 OC 风险。本荟萃分析旨在分析 RRSO 对 BRCA1/2 基因突变携带者 BC 风险的影响。
检索 Embase、PubMed、Web of Science 和 Cochrane 数据库，以获取所有研究 RRSO 对 BC 风险影响的研究。使用汇总结果来评估 RRSO 与 BC 风险之间的关联。
本荟萃分析纳入了来自 14 项观察性研究的 13965 名 BRCA1 和 7057 名 BRCA2 基因突变携带者。汇总结果表明，RRSO 降低了 BRCA1 基因突变携带者的 BC 风险[风险比（HR）=0.63，95%置信区间（CI）：0.49-0.81，P<0.01]和 BRCA2 基因突变携带者（HR=0.51，95%CI：0.34-0.75，P<0.01）。RRSO 降低了 BRCA1 基因突变的年轻女性的 BC 风险（HR=0.48，95%CI：0.30-0.77，P<0.01）和 BRCA2 基因突变携带者（HR=0.22，95%CI：0.08-0.65，P<0.01）。对手术后不同时间间隔 RRSO 疗效的分析显示，BRCA1 基因突变携带者术后<5 年的 BC 风险降低（HR=0.60，95%CI：0.40-0.89，P=0.01）和 BRCA2 基因突变携带者（HR=0.42，95%CI：0.20-0.86，P=0.02）。
RRSO 是降低 BRCA1/2 基因突变女性 BC 风险的有效方法，尤其是年轻女性。BRCA1/2 基因突变携带者可以从手术后的 5 年内从 RRSO 中获益。
