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Genetics of Breast and Ovarian Cancer (PDQ®)

  • Updated: 07/11/2014

Table 15. Uptake of Risk-reducing Salpingo-oophorectomy (RRSO) and/or Gynecologic Screening Among BRCA1 and BRCA2 Mutation Carriers

Study Citation Study Population  Uptake of RRSO Uptake of Gynecologic Screening Length of Follow-up Comments 
United States
Scheuer et al. (2002) [225]Carriers (n = 179)a Carriers 50.3%CA-125 Mean, 24.8 mo; range, 1.6–66.0 moWomen undergoing RRSO were older and more likely to have a personal history of breast cancer.
– Carriers 67.6%
TVUS
– Carriers 72.9%
Beattie et al. (2009) [217]Carriers (n = 240)bCarriers 51%Not applicableMean, 3.7 yWomen opting for RRSO <60 y had a prior diagnosis of breast cancer and also underwent RRM.
Median time to RRSO: 123 days from receiving results.
O'Neill et al. (2010) [218]Carriers (n = 146)aCarriers 32%Not applicable12 mo
Schwartz et al. (2012) [219]Carriers (n = 100)aCarriers 65%CA-125 Mean, 5.3 yPredictors of RRSO were being ≥40 y and having received a diagnosis of breast cancer more than 10 y ago.
Noncarriers (n = 52)aNoncarriers 1.9%– Carriers 56%
– Noncarriers 12%
– Uninformative 33%
Uninformative (n = 203)aUninformative 13.3%TVUS
– Carriers 42%
– Noncarriers 20%
– Uninformative 26%
Garcia et al. (2013) [220]Carriers (n = 305)bCarriers 74%Excluding women post-RRSO:41 mo; range, 26–66 moOvarian surveillance decreased significantly from years 1–5 of follow-up; CA-125: 47% to 2%; TVUS: 45% to 2.3%
CA-125
– Carriers 47%
TVUS
– Carriers 45%
Mannis et al. (2013) [226]Carriers (n = 201)aCarriers 69.6%CA-125 Median, 3.7 yPredictors of RRSO and screening included being a BRCA mutation carrier, age 40–49 y, having a higher income, ≥2 children, a personal history of breast cancer, and a first-degree relative with ovarian cancer.
– 26.3%
TVUS
– 26.3%
Noncarriers (n = 103)aNoncarriers 2.0%Not reported
Uninformative (n = 773)a; 59/773 with a variant of uncertain significanceUninformative 12.3%CA-125
– 10.4%
TVUS
– 6.5%
Singh et al. (2013) [221]Carriers (n = 136)bCarriers 52%Not applicableRange, 1–11 yPredictors of RRSO were first- or second-degree relative with breast cancer, a mother lost to pelvic cancer, having had ≥1 childbirths, age ≥50 y, and having undergone testing after 2005.
International
Phillips et al. (2006) [222]Carriers (n = 70)aCarriers 29%CA-125 3 y
– Carriers 0%
TVUS
– Carriers 67%
Friebel et al. (2007) [227]Carriers (N = 537)cCarriers 55%Not applicableMinimum 6 mo; median 36 moRRSO greatest in parous women >40 y.
Madalinska et al. (2007) [228]Carriers (n = 160)a, bCarriers 74%Carriers 26%12 moWomen who underwent RRSO had lower education levels, viewed ovarian cancer as incurable, and believed strongly in the benefits of RRSO.
Specific method(s) of gynecological screening not reported.
Metcalfe et al. (2008) [223]Carriers (N = 2,677)aCarriers 57%Not applicable3.9 y; range, 1.5–10.3 yLarge differences in uptake of risk management options by country.
Julian-Reynier et al. (2011) [224]Carriers (n = 101)aCarriers 42.6%TVUS 5 yRRSO uptake increased with age. Having undergone RRSO did not alter breast cancer risk perception. Noncarriers often continued screening.
Noncarriers (n = 145)aNoncarriers 2%– Noncarriers 43.2%
Rhiem et al. (2011) [229]Carriers (N = 306)bCarriers 57%Not evaluatedMean, 47.8 mo post-oophorectomyMedian age at time of RRSO = 47 y. One occult fallopian tube cancer was detected at the time of RRSO. One peritoneal carcinoma was diagnosed 26 mo post-RRSO.
Sidon et al. (2012) [230]Carriers (N = 700)a; 386/700 with personal history of breast cancerBRCA1 carriers:Not evaluatedAffected with breast cancer Uptake of RRSO was lower in women >60 y (22% uptake at 5 y). None of the women >70 y had a RRSO performed.
– 54.5%
BRCA2 carriers:BRCA1: Mean, 2.29; range, 0.1–11.45 y
– 45.5%
All carriers with no personal history of breast cancerBRCA2: Mean, 1.77; range, 0.1–11.1 y
Not affected with breast cancer
– 54.2%
All carriers with personal history of breast cancerBRCA1: Mean, 1.63; range, 0.1–11.28 y
– 43.2%BRCA2: Mean, 1.75; range, 0.1–8.98 y

CA-125 = cancer antigen 125; RRM = risk-reducing mastectomy; TVUS = transvaginal ultrasound.
aSelf-report as data source.
bMedical records as data source.
cData source not specified.

References

  1. Beattie MS, Crawford B, Lin F, et al.: Uptake, time course, and predictors of risk-reducing surgeries in BRCA carriers. Genet Test Mol Biomarkers 13 (1): 51-6, 2009.  [PUBMED Abstract]

  2. O'Neill SC, Valdimarsdottir HB, Demarco TA, et al.: BRCA1/2 test results impact risk management attitudes, intentions, and uptake. Breast Cancer Res Treat 124 (3): 755-64, 2010.  [PUBMED Abstract]

  3. Schwartz MD, Isaacs C, Graves KD, et al.: Long-term outcomes of BRCA1/BRCA2 testing: risk reduction and surveillance. Cancer 118 (2): 510-7, 2012.  [PUBMED Abstract]

  4. Garcia C, Wendt J, Lyon L, et al.: Risk management options elected by women after testing positive for a BRCA mutation. Gynecol Oncol 132 (2): 428-33, 2014.  [PUBMED Abstract]

  5. Singh K, Lester J, Karlan B, et al.: Impact of family history on choosing risk-reducing surgery among BRCA mutation carriers. Am J Obstet Gynecol 208 (4): 329.e1-6, 2013.  [PUBMED Abstract]

  6. Phillips KA, Jenkins MA, Lindeman GJ, et al.: Risk-reducing surgery, screening and chemoprevention practices of BRCA1 and BRCA2 mutation carriers: a prospective cohort study. Clin Genet 70 (3): 198-206, 2006.  [PUBMED Abstract]

  7. Metcalfe KA, Birenbaum-Carmeli D, Lubinski J, et al.: International variation in rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers. Int J Cancer 122 (9): 2017-22, 2008.  [PUBMED Abstract]

  8. Julian-Reynier C, Mancini J, Mouret-Fourme E, et al.: Cancer risk management strategies and perceptions of unaffected women 5 years after predictive genetic testing for BRCA1/2 mutations. Eur J Hum Genet 19 (5): 500-6, 2011.  [PUBMED Abstract]

  9. Scheuer L, Kauff N, Robson M, et al.: Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J Clin Oncol 20 (5): 1260-8, 2002.  [PUBMED Abstract]

  10. Mannis GN, Fehniger JE, Creasman JS, et al.: Risk-reducing salpingo-oophorectomy and ovarian cancer screening in 1077 women after BRCA testing. JAMA Intern Med 173 (2): 96-103, 2013.  [PUBMED Abstract]

  11. Friebel TM, Domchek SM, Neuhausen SL, et al.: Bilateral prophylactic oophorectomy and bilateral prophylactic mastectomy in a prospective cohort of unaffected BRCA1 and BRCA2 mutation carriers. Clin Breast Cancer 7 (11): 875-82, 2007.  [PUBMED Abstract]

  12. Madalinska JB, van Beurden M, Bleiker EM, et al.: Predictors of prophylactic bilateral salpingo-oophorectomy compared with gynecologic screening use in BRCA1/2 mutation carriers. J Clin Oncol 25 (3): 301-7, 2007.  [PUBMED Abstract]

  13. Rhiem K, Foth D, Wappenschmidt B, et al.: Risk-reducing salpingo-oophorectomy in BRCA1 and BRCA2 mutation carriers. Arch Gynecol Obstet 283 (3): 623-7, 2011.  [PUBMED Abstract]

  14. Sidon L, Ingham S, Clancy T, et al.: Uptake of risk-reducing salpingo-oophorectomy in women carrying a BRCA1 or BRCA2 mutation: evidence for lower uptake in women affected by breast cancer and older women. Br J Cancer 106 (4): 775-9, 2012.  [PUBMED Abstract]