Uptake of risk-reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age, and time dependent.

2.50
Hdl Handle:
http://hdl.handle.net/10541/85184
Title:
Uptake of risk-reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age, and time dependent.
Authors:
Evans, D Gareth R; Lalloo, Fiona; Ashcroft, Linda; Shenton, Andrew; Clancy, Tara; Baildam, Andrew D; Brain, Anne; Hopwood, Penelope; Howell, Anthony ( 0000-0002-3879-5991 )
Abstract:
PURPOSE: The uptake of risk-reducing surgery in women at increased risk of breast and ovarian cancer is highly variable between countries and centers within countries. We have investigated the rate, timing, and age of uptake of surgery in the northwest of England to report the results after up to 7 years in a Regional Genetics center. METHODS: Uptake was documented in 211 known unaffected BRCA1/2 mutation carriers from 509 families and in 3,515 women at >25% lifetime risk of breast cancer without known mutations. RESULTS: Of the 211 mutation carriers, 40% opted for bilateral risk-reducing mastectomy (BRRM) and 45% underwent bilateral risk-reducing salpingo-oophorectomy (BRRSPO). Uptake of BRRM was significantly related to lifetime risk and age but continued over several years. In women not known to carry a BRCA mutation, 6.4% of women at 40% to 45% lifetime risk, 2.5% of women at 33% to 39% lifetime risk, and 1.8% of women at 25% to 32% lifetime risk underwent BRRM (P < 0.005). BRRSPO uptake was greater in BRCA1 (52%) than BRCA2 (28%) carriers but in both groups tended to occur within the first 2 years after gene test (except in the youngest age group) and in women between the ages of 35 and 45. CONCLUSION: To truly assess the uptake of risk-reducing surgery, longer-term follow-up is necessary particularly in younger women who are likely to delay BRRSPO. Careful risk counseling does seem to influence women's decisions for surgery, although the effect is not immediate.
Affiliation:
Regional Genetic Service, The University of Manchester, St.Mary's Hospital, Manchester, United Kingdom. Gareth.evans@cmft.nhs.uk
Citation:
Uptake of risk-reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age, and time dependent. 2009, 18 (8):2318-24 Cancer Epidemiol. Biomarkers Prev.
Journal:
Cancer Epidemiology, Biomarkers & Prevention
Issue Date:
Aug-2009
URI:
http://hdl.handle.net/10541/85184
DOI:
10.1158/1055-9965.EPI-09-0171
PubMed ID:
19661091
Type:
Article
Language:
en
ISSN:
1538-7755
Appears in Collections:
All Christie Publications ; Medical Oncology

Full metadata record

DC FieldValue Language
dc.contributor.authorEvans, D Gareth Ren
dc.contributor.authorLalloo, Fionaen
dc.contributor.authorAshcroft, Lindaen
dc.contributor.authorShenton, Andrewen
dc.contributor.authorClancy, Taraen
dc.contributor.authorBaildam, Andrew Den
dc.contributor.authorBrain, Anneen
dc.contributor.authorHopwood, Penelopeen
dc.contributor.authorHowell, Anthonyen
dc.date.accessioned2009-11-02T16:34:35Z-
dc.date.available2009-11-02T16:34:35Z-
dc.date.issued2009-08-
dc.identifier.citationUptake of risk-reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age, and time dependent. 2009, 18 (8):2318-24 Cancer Epidemiol. Biomarkers Prev.en
dc.identifier.issn1538-7755-
dc.identifier.pmid19661091-
dc.identifier.doi10.1158/1055-9965.EPI-09-0171-
dc.identifier.urihttp://hdl.handle.net/10541/85184-
dc.description.abstractPURPOSE: The uptake of risk-reducing surgery in women at increased risk of breast and ovarian cancer is highly variable between countries and centers within countries. We have investigated the rate, timing, and age of uptake of surgery in the northwest of England to report the results after up to 7 years in a Regional Genetics center. METHODS: Uptake was documented in 211 known unaffected BRCA1/2 mutation carriers from 509 families and in 3,515 women at >25% lifetime risk of breast cancer without known mutations. RESULTS: Of the 211 mutation carriers, 40% opted for bilateral risk-reducing mastectomy (BRRM) and 45% underwent bilateral risk-reducing salpingo-oophorectomy (BRRSPO). Uptake of BRRM was significantly related to lifetime risk and age but continued over several years. In women not known to carry a BRCA mutation, 6.4% of women at 40% to 45% lifetime risk, 2.5% of women at 33% to 39% lifetime risk, and 1.8% of women at 25% to 32% lifetime risk underwent BRRM (P < 0.005). BRRSPO uptake was greater in BRCA1 (52%) than BRCA2 (28%) carriers but in both groups tended to occur within the first 2 years after gene test (except in the youngest age group) and in women between the ages of 35 and 45. CONCLUSION: To truly assess the uptake of risk-reducing surgery, longer-term follow-up is necessary particularly in younger women who are likely to delay BRRSPO. Careful risk counseling does seem to influence women's decisions for surgery, although the effect is not immediate.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectOvarian Canceren
dc.subject.meshAdult-
dc.subject.meshAge Factors-
dc.subject.meshBreast Neoplasms-
dc.subject.meshEngland-
dc.subject.meshFemale-
dc.subject.meshGenes, BRCA1-
dc.subject.meshGenes, BRCA2-
dc.subject.meshGenetic Predisposition to Disease-
dc.subject.meshHumans-
dc.subject.meshMastectomy-
dc.subject.meshMiddle Aged-
dc.subject.meshMutation-
dc.subject.meshOvarian Neoplasms-
dc.subject.meshOvariectomy-
dc.subject.meshRisk Factors-
dc.subject.meshTime-
dc.titleUptake of risk-reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age, and time dependent.en
dc.typeArticleen
dc.contributor.departmentRegional Genetic Service, The University of Manchester, St.Mary's Hospital, Manchester, United Kingdom. Gareth.evans@cmft.nhs.uken
dc.identifier.journalCancer Epidemiology, Biomarkers & Preventionen

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