PDF(Pubmed)
Abstract：
Risk-reducing surgeries are an option for cancer risk management in BRCA1/2 individuals. However, while adnexectomy is commonly recommended in breast cancer (BC) survivors, risk-reducing bilateral breast surgery (RRBBS) is controversial in ovarian cancer (OC) survivors due to relapse rates and mortality.
We conducted a retrospective analysis of BRCA1/2-OC survivors, with OC as first cancer diagnosis.
Median age at OC diagnosis for the 69 BRCA1/2-OC survivors was 54 years. Median overall survival was 8 years, being significantly higher for BRCA2 patients than for BRCA1 patients (p = 0.011). Nine patients (13.2%) developed BC at a median age of 61 years. The mean overall BC-free survival was 15.5 years (median not reached). Eight patients (11.8%) underwent bilateral mastectomy (5 simultaneous with BC treatment; 3 RRBBS) at a median age of 56.5 years. The median time from OC to bilateral mastectomy/RRBBS was 5.5 years.
This study adds evidence regarding a lower BC risk after BRCA1/2-OC and higher survival for BRCA2-OC patients. A comprehensive analysis of the competing risks of OC mortality and recurrence against the risk of BC should be individually addressed. Surgical BC risk management may be considered for longer BRCA1/2-OC disease-free survivors. Ultimately, these decisions should always be tailored to patients\' characteristics and preferences.
We conducted a retrospective analysis of BRCA1/2-OC survivors, with OC as first cancer diagnosis.
Median age at OC diagnosis for the 69 BRCA1/2-OC survivors was 54 years. Median overall survival was 8 years, being significantly higher for BRCA2 patients than for BRCA1 patients (p = 0.011). Nine patients (13.2%) developed BC at a median age of 61 years. The mean overall BC-free survival was 15.5 years (median not reached). Eight patients (11.8%) underwent bilateral mastectomy (5 simultaneous with BC treatment; 3 RRBBS) at a median age of 56.5 years. The median time from OC to bilateral mastectomy/RRBBS was 5.5 years.
This study adds evidence regarding a lower BC risk after BRCA1/2-OC and higher survival for BRCA2-OC patients. A comprehensive analysis of the competing risks of OC mortality and recurrence against the risk of BC should be individually addressed. Surgical BC risk management may be considered for longer BRCA1/2-OC disease-free survivors. Ultimately, these decisions should always be tailored to patients\' characteristics and preferences.
摘要：
背景：降低风险手术是BRCA1/2个体癌症风险管理的一种选择。然而,虽然附件切除术通常推荐用于乳腺癌（BC）幸存者，由于复发率和死亡率,降低风险的双侧乳腺手术(RRBBS)在卵巢癌(OC)幸存者中存在争议.
方法：我们对BRCA1/2-OC幸存者进行了回顾性分析，以OC作为第一个癌症诊断。
结果：69名BRCA1/2-OC幸存者在OC诊断时的中位年龄为54岁。中位总生存期为8年,BRCA2患者明显高于BRCA1患者（p=0.011）。9名患者（13.2％）的中位年龄为61岁。平均总无BC生存期为15.5年（中位数未达到）。8例患者（11.8％）接受了双侧乳房切除术（5例同时接受BC治疗；3例RRBBS），中位年龄为56.5岁。从OC到双侧乳房切除术/RRBBS的中位时间为5.5年。
结论：这项研究增加了关于BRCA1/2-OC后BC风险较低和BRCA2-OC患者生存率较高的证据。应单独解决对OC死亡率和复发与BC风险的竞争性风险的全面分析。对于更长的BRCA1/2-OC无病幸存者，可以考虑进行手术BC风险管理。最终,这些决定应始终根据患者的特征和偏好进行调整。
方法：我们对BRCA1/2-OC幸存者进行了回顾性分析，以OC作为第一个癌症诊断。
结果：69名BRCA1/2-OC幸存者在OC诊断时的中位年龄为54岁。中位总生存期为8年,BRCA2患者明显高于BRCA1患者（p=0.011）。9名患者（13.2％）的中位年龄为61岁。平均总无BC生存期为15.5年（中位数未达到）。8例患者（11.8％）接受了双侧乳房切除术（5例同时接受BC治疗；3例RRBBS），中位年龄为56.5岁。从OC到双侧乳房切除术/RRBBS的中位时间为5.5年。
结论：这项研究增加了关于BRCA1/2-OC后BC风险较低和BRCA2-OC患者生存率较高的证据。应单独解决对OC死亡率和复发与BC风险的竞争性风险的全面分析。对于更长的BRCA1/2-OC无病幸存者，可以考虑进行手术BC风险管理。最终,这些决定应始终根据患者的特征和偏好进行调整。
