AB202. SOH25_AB_322. Impact of risk-reducing bilateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers: a systematic review and meta-analysis
General Posters II

AB202. SOH25_AB_322. Impact of risk-reducing bilateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers: a systematic review and meta-analysis

Cathal O’Reilly1, Jennifer McGarry1, Alexandra Zaborowski1, Michael Boland2, Denis Evoy2, Jane Rothwell2, Ruth Prichard2, Damian McCartan2, Claire Rutherford2

1Department of Surgery, Royal College of Surgeons, Dublin, Ireland; 2Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: Risk-reducing bilateral mastectomy (RRBM) is known to reduce the incidence of breast cancer in BRCA pathogenic mutation carriers, but the effect on survival has not been definitively established. The aim of this study was to compare overall and breast cancer-specific mortality in confirmed BRCA carriers undergoing RRBM compared with surveillance alone.

Methods: The study was performed in according with Systematic reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search of major scientific databases was undertaken. Selection criteria were applied, and the relevant studies were included in the final review and meta-analysis. A risk of bias assessment was undertaken for each paper, risk ratios (RRs) were calculated and propensity-adjusted hazard ratios (HRs) were pooled to assess for differences in outcomes.

Results: Four papers met the selection criteria for the study, with a total of 5,449 patients included in our meta-analysis. RRBM was associated with improved overall mortality in BRCA1 and BRCA2 mutation carriers in both unadjusted [RR 0.26, 95% confidence interval (CI): 0.17–0.42; P<0.001] and adjusted (HR 0.28, 95% CI: 0.22–0.64; P<0.001] analyses; RRBM did not have a statistically significant association with an improvement in breast cancer mortality (RR 0.30, 95% CI: 0.07–1.28; P=0.10).

Conclusions: Bilateral mastectomy as a risk-reducing procedure in BRCA mutation carriers appears to improve overall mortality rates but not breast cancer-specific mortality. Advising patients of this information is important when undertaking shared decisions in this cohort.

Keywords: Risk reducing mastectomy; BRCA1 protein; BRCA2 protein; breast neoplasms; meta-analysis

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab202
Cite this abstract as: O’Reilly C, McGarry J, Zaborowski A, Boland M, Evoy D, Rothwell J, Prichard R, McCartan D, Rutherford C. AB202. SOH25_AB_322. Impact of risk-reducing bilateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers: a systematic review and meta-analysis. Mesentery Peritoneum 2025;9:AB202.

Article Options

Download Citation

Share