The impact of oophorectomy on survival after breast cancer in BRCA1-positive breast cancer patients.

Abstract

The aim of the study is to identify treatments which predict survival for women with a BRCA1 mutation, including oophorectomy and chemotherapy. 476 women with stage I to stage III breast cancer who carried a BRCA1 mutation were followed from diagnosis until April 2015. Information on treatment was obtained from chart review and patient questionnaires. Dates of death were obtained from the Poland vital statistics registry. Survival curves were compared for different subgroups according to treatment received. Predictors of overall survival were determined using the Cox proportional hazards model. The ten-year overall survival was 78.3% (95% CI 74.2-82.6%) and the ten-year breast cancer-specific survival was 84.2% (95% CI 80.5-88.0%). Sixty-two patients died of breast cancer, 14 patients died of ovarian cancer, and 2 patients died of peritoneal cancer. Oophorectomy was associated with a significant reduction in all-cause mortality in the entire cohort (adjusted HR=0.41; 95% CI 0.24-0.69; p=0.0008) and in breast cancer-specific mortality among ER-negative breast cancer patients (HR=0.44; 95% CI 0.22-0.89; p=0.02). Among women with breast cancer and a BRCA1 mutation, survival is greatly improved by oophorectomy due to the prevention of deaths from both breast and ovarian cancer.