Bilateral Prophylactic Mastectomy Reduces Breast Cancer Risk in BRCA1 and BRCA2 Mutation Carriers: The PROSE Study Group
Abstract
Purpose Data on the efficacy of bilateral prophylactic mastectomy for breast cancer risk reduction in women with BRCA1 and BRCA2 (BRCA1/2) mutations are limited, despite the clinical use of this risk-management strategy. Thus, we estimated the degree of breast cancer risk reduction after surgery in women who carry these mutations. Patients and methods Four hundred eighty-three women with disease-associated germline BRCA1/2 mutations were studied for the occurrence of breast cancer. Cases were mutation carriers who underwent bilateral prophylactic mastectomy and who were followed prospectively from the time of their center ascertainment and their surgery, with analyses performed for both follow-up periods. Controls were BRCA1/2 mutation carriers with no history of bilateral prophylactic mastectomy matched to cases on gene, center, and year of birth. Both cases and controls were excluded for previous or concurrent diagnosis of breast cancer. Analyses were adjusted for duration of endogenous ovarian hormone exposure, including age at bilateral prophylactic oophorectomy if applicable. Results Breast cancer was diagnosed in two (1.9%) of 105 women who had bilateral prophylactic mastectomy and in 184 (48.7%) of 378 matched controls who did not have the procedure, with a mean follow-up of 6.4 years. Bilateral prophylactic mastectomy reduced the risk of breast cancer by approximately 95% in women with prior or concurrent bilateral prophylactic oophorectomy and by approximately 90% in…
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Prophylactic bilateral mastectomy has been shown to reduce the incidence of breast cancer by approximately 90% in BRCA1/2 mutation carriers.
“which has been shown to reduce the incidence of breast cancer by approximately 90% [57-59]”
From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of <i>BRCA1</i> or <i>BRCA2</i> Pathogenic Variants (2026) · cites this paper as [57]
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“In the only other study of BRCA1/2 mutation carriers to date, Meijers-Heijboer et al [6] reported no postbilateral prophylactic mastectomy breast cancers in 76 BRCA1/2 mutation carriers after 2.”
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- Authors
- Rebbeck, T. R., Friebel, T., Lynch, H. T., Neuhausen, S. L., van ’t Veer, L., Garber, J. E., Evans, G. R., Narod, S. A., Isaacs, C., Matloff, E., Daly, M. B., Olopade, O. I., & Weber, B. L.
- Affiliations
- Creighton University (US)
- From the PROSE Study Group; the Center for Clinical Epidemiology and Biostatistics, Abramson Family Cancer Research Institute, The University of Pennsylvania; and Fox Chase Cancer Center, Philadelphia, PA; Creighton University, Omaha, NE; Division of Genetic Epidemiology, Department of Medicine, University of California Irvine, Irvine, CA; Women’s College Hospital, Toronto, Ontario, Canada; the Netherlands Cancer Institute, Amsterdam, the Netherlands; Dana-Farber Cancer Institute, Boston, MA; St. Mary’s...
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2004-03-15
- Volume
- 22
- Issue
- 6
- Pages
- 1055-1062
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2147058464
- Cited by
- 1,171
- References
- 2
- Citations by year
- 2026: 25 · 2025: 25 · 2024: 45 · 2023: 43 · 2022: 55 · 2021: 48 · 2020: 36 · 2019: 51 · 2018: 57 · 2017: 59 · 2016: 67 · 2015: 52 · 2014: 62 · 2013: 53 · 2012: 51
- FWCI
- 32.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- Funders
- National Institutes of Health (5r01ca057601-07)
- National Cancer Institute (R01-CA83855, CA-57601, R01CA083855, CA74415, N01 CN6700, R01CA074415)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
- Keywords
- bilateral prophylactic mastectomy, breast cancer risk reduction, BRCA1 mutation, BRCA2 mutation, germline mutation carriers, prophylactic oophorectomy, breast cancer prevention
- MeSH terms
- Adult, Breast Neoplasms, Europe, Female, Heterozygote, Humans, Mastectomy, Middle Aged, Mutation, North America, Prospective Studies, Retrospective Studies, Proportional Hazards Models, Case-Control Studies, Treatment Outcome, Risk Assessment, Genes, BRCA1, Genetic Predisposition to Disease, Genes, BRCA2
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