Prophylactic oophorectomy may differentially reduce breast cancer risk in women with BRCA1 versus BRCA2 mutations

Abstract

Multiple studies have shown that risk-reducing salpingo-oophorectomy (RRSO) not only reduces the risk of gynecologic cancer
(ovarian, fallopian tube, and primary peritoneal) cancer in women with mutations in either BRCA1 or BRCA2, but that if performed premenopausally, RRSO also reduces the risk of breast cancer. It has, however, become apparent that
mutations in BRCA1 and BRCA2 cause related, but distinct, cancer susceptibility syndromes. For example, BRCA1-associated breast cancer is markedly more likely to be estrogen receptor negative than BRCA2-associated breast cancer. Similarly, the ovarian cancer penetrance is substantially lower for carriers of BRCA2 mutations than for carriers of BRCA1 mutations. These differences raise the question as to whether RRSO may have different impacts on cancer risk depending on
the specific gene mutated. This article reviews what is known about RRSO for reducing BRCA-associated breast and gynecologic cancer risk, as well as early data suggesting RRSO may have differential effects depending
upon whether BRCA1 or BRCA2 is mutated.