title: Bilateral risk-reduction mastectomy in BRCA1 and BRCA2 mutation carriers: a meta-analysis.
abstract: BACKGROUND
  Women with BRCA1 and BRCA2 mutations have substantially elevated risk of developing breast cancer. The aim of this study was to clarify the role of bilateral risk-reducing mastectomy (BRRM) in reducing breast cancer risk in women carriers of BRCA1 and BRCA2 mutations.
  
  
  METHODS
  The Pubmed, MEDLINE and Scopus databases were searched to retrieve articles written in the English language. Two investigators independently extracted the characteristics and results of the selected studies. Only prospective trials with available absolute numbers of breast cancer and death events were included. Pooled hazard ratio (HR) with 95 % confidence interval (CI) was calculated using fixed or random effects model.
  
  
  RESULTS
  Meta-analysis of four prospective studies, including 2635 patients, demonstrated a significant risk reduction of breast cancer incidence in BRCA1 and BRCA2 mutation carriers receiving BRRM (HR 0.07; 95 % CI 0.01-0.44; p = 0.004). Among patients without previous risk-reducing salpingo-oophorectomy, a significant benefit was similarly recorded (HR 0.06; 95 % CI 0.01-0.41; p = 0.005).
  
  
  CONCLUSIONS
  Performing BRRM may lead to highly significant risk reduction of breast cancer in BRCA1 and BRCA2 mutation carriers. These data allow clinicians to discuss more in-depth with patients all the available options in order to design better management strategies.
authors: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy.
authors: Francesca
authors: F
authors: De Felice
authors: Claudia
authors: C
authors: Marchetti
authors: Angela
authors: A
authors: Musella
authors: Innocenza
authors: I
authors: Palaia
authors: Giorgia
authors: G
authors: Perniola
authors: Daniela
authors: D
authors: Musio
authors: Ludovico
authors: L
authors: Muzii
authors: Vincenzo
authors: V
authors: Tombolini
authors: Pierluigi
authors: P
authors: Benedetti Panici
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000601:surgery; D005260:Female; D006579:Heterozygote; D006801:Humans; D008408:Mastectomy; D009154:Mutation / Q000235:genetics*; D011379:Prognosis; D011446:Prospective Studies; D040242:Risk Reduction Behavior
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human