title: 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.
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Huzarski
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Byrski
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Gronwald
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: C
authors.initials: C
authors.lastname: Cybulski
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: O
authors.initials: O
authors.lastname: Oszurek
authors.affiliation: Regional Oncology Center, Opole, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Szwiec
authors.affiliation: Department of Pathology, District Specialist Hospital, Olsztyn, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Gugała
authors.affiliation: Regional Oncology Center, Poznań, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Stawicka
authors.affiliation: Department of Oncological Surgery, Regional Oncology Center, Łódź, Poland.
authors.forename: Z
authors.initials: Z
authors.lastname: Morawiec
authors.affiliation: Regional Oncology Hospital, Bydgoszcz, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Mierzwa
authors.affiliation: Regional Oncology Hospital, Szczecin, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Falco
authors.affiliation: Department of Clinical Genetics, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: H
authors.initials: H
authors.lastname: Janiszewska
authors.affiliation: Department of Oncology, Disctict Specialist Hospital, Świdnica, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Kilar
authors.affiliation: Department of Oncological Surgery, Regional Oncology Center, Kraków, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Marczyk
authors.affiliation: Regional Oncology Center, Kielce, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Kozak-Klonowska
authors.affiliation: Regional Oncology Center, Kielce, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Siołek
authors.affiliation: St. John's Cancer Center, Lublin, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Surdyka
authors.affiliation: Regional Oncology Hospital, Bielsko Biała, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Wiśniowski
authors.affiliation: Regional Oncology Center, Białystok, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Posmyk
authors.affiliation: Department of Pathology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Domagała
authors.affiliation: Women's College Research Institute, 76 Grenville, Suite 6422, Toronto, ON, M5S 1B2, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Sun
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, 70-115, Szczecin, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Lubiński
authors.affiliation: Women's College Research Institute, 76 Grenville, Suite 6422, Toronto, ON, M5S 1B2, Canada. steven.narod@wchospital.ca.
authors.forename: S A
authors.identifier: http://orcid.org/0000-0001-5798-0626
authors.initials: SA
authors.lastname: Narod
mesh_terms: D000328:Adult; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000401:mortality*; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000601:surgery; D010052:Ovariectomy / Q000379:methods*; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human
keywords: BRCA1; Breast cancer; Prognostic factors; Survival