EMBARGOED FOR RELEASE
February 11, 2008, 6 PM (EST) 703-519-1422

CONTACT:
Danielle Potuto
potutod@asco.org

Alexandria, Va.—A new study finds that the cancer risk reduction resulting from the removal of the ovaries and fallopian tubes in women who are at genetically high risk for breast and gynecological cancer varies according to the type of genetic mutation present. The study is being published online February 11 in the Journal of Clinical Oncology (JCO).

The researchers found that women with mutations in the BRCA2 gene have nearly twice the reduction in breast cancer risk following the surgery compared to women with BRCA1 mutations. The study also found that women with BRCA1 mutations have a significantly reduced risk of gynecologic (ovarian, fallopian tube or primary peritoneal) cancer, but the study was not able to estimate the level of reduced risk for women with BRCA2 mutations, due to a lower incidence of gynecologic cancers in these women.

“These findings should help women with BRCA mutations and their doctors make more informed choices about strategies to reduce their risk of breast and gynecological cancers,” said lead author Noah D. Kauff, MD, assistant attending physician in the Clinical Genetics and Gynecology Services at Memorial Sloan-Kettering Cancer Center. “In women with BRCA2 mutations, prophylactic removal of the ovaries and fallopian tubes is profoundly protective against breast cancer. Although the surgery greatly reduces gynecologic cancer risk in women with BRCA1 mutations, they may need to pursue other strategies, such as intensive monitoring or prophylactic mastectomy, to reduce their breast cancer risk.”

Previous studies have shown that the surgery, called “risk-reducing salpingo-oophorectomy” (RRSO), lowers the risk of breast and gynecologic cancers in women at high risk due to BRCA mutations, but those studies either analyzed BRCA1 mutation carriers alone or BRCA1 and BRCA2 mutation carriers as a group. This is the first prospective study to evaluate the effectiveness of this surgery in BRCA1 and BRCA2 mutation carriers separately.

Researchers compared the incidence of breast and gynecologic cancers between 509 women 30 years of age or older with a BRCA1 or BRCA2 mutation who had RRSO surgery, and 283 women with these mutations who did not have the surgery. Participants were enrolled in the study beginning in November 1994 and were followed through November 2005.

After an average three years of follow-up, RRSO reduced breast cancer risk in women with a BRCA2 mutation by 72 percent, compared with 39 percent among those with a BRCA1 mutation. The surgery reduced gynecologic cancer risk in women with a BRCA1 mutation by 85 percent. Because very few gynecologic cancers were observed in the BRCA2 group, researchers were not able to conclude the level of risk reduction for these women.

The investigators also found that RRSO markedly reduced the risk of developing estrogen receptor (ER)-positive breast cancer (by 78 percent) in the group overall, but had no significant effect on the development of ER-negative breast cancer. Dr. Kauff noted that women with BRCA1 mutations, in whom ER-negative breast cancers are more common, should also consider other risk-reduction strategies to protect against this type of breast cancer.

"Effect Risk-Reducing Salpingo-Oophorectomy for the Prevention of BRCA1- and BRCA2-Associated Breast and Gynecologic Cancer: A Multicenter, Prospective Study." Noah D. Kauff, et al, Memorial Sloan-Kettering Cancer Center, New York, NY.

A consumer information piece on this study can be found on ASCO’s patient website, People LivingWith Cancer.org, at www.plwc.org/CancerAdvances at the time of embargo lift. For more information about breast and ovarian cancer treatment, visit www.plwc.org/breast and www.plwc.org/ovarian.

The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world’s leading professional society representing physicians who treat people with cancer.

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