Risk reducing mastectomy in Norwegian BRCA1/2 carriers
Hanne Kjensli Hyldebrandt1, Astrid Tenden Stormorken2, Valeria Vitelli3
1Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Summary
Nearly half of BRCA1/2 carriers underwent risk-reducing mastectomy (RRM), with uptake increasing since 2008. BRCA1 carriers opted for RRM more frequently and at a younger age than BRCA2 carriers, with low post-surgery breast cancer incidence.
Area of Science:
- Oncology
- Genetics
- Preventive Medicine
Background:
- Risk-reducing mastectomy (RRM) is a key option for individuals with pathogenic germline variants in BRCA1 or BRCA2 (BRCA1/2).
- Understanding RRM uptake trends is crucial for personalized cancer prevention strategies.
Purpose of the Study:
- To investigate and compare RRM uptake among Norwegian BRCA1/2 carriers from 2008 to 2021.
- To analyze temporal trends in RRM uptake and the incidence of breast cancer (BC) following the procedure.
Main Methods:
- Retrospective study of 1237 BRCA1/2 carriers tested at Oslo University Hospital (2008-2021).
- Data on RRM, genetic testing (GT), and subsequent BC diagnoses were collected from national registries.
- RRM uptake was analyzed by gene, age at GT, and time period of testing.
Main Results:
- 48.8% of BRCA1/2 carriers chose RRM, with higher uptake in BRCA1 (54.5%) versus BRCA2 (42.0%) carriers.
- Women tested in 2015/2016 were 2.6 times more likely to undergo RRM than those tested in 2008/2009.
- Breast cancer developed in only 0.3% of patients post-RRM.
Conclusions:
- RRM uptake has increased among BRCA1/2 carriers since 2008.
- BRCA1 carriers demonstrated higher RRM uptake, earlier age at surgery, and shorter time from GT to RRM compared to BRCA2 carriers.
- RRM is associated with a low incidence of subsequent breast cancer.
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