Bilateral Salpingo-Oophorectomy Reduces Mortality Risk in BRCA Carriers

Strategic Insights -

Women carrying pathogenic variants in BRCA1 and BRCA2 genes with a personal history of breast cancer who underwent bilateral salpingo-oophorectomy (BSO) significantly reduced their risk of all-cause mortality and breast cancer-specific mortality. According to a study published in The Lancet Oncology, BSO was associated with a reduced risk of a second non-breast cancer in the combined BRCA1 and BRCA2 sample. The study used data from the National Cancer Registration Dataset and the Hospital Episode Statistics-Admitted Patient Care dataset, including 1,674 BRCA1, 1,740 BRCA2, and nine BRCA1 and BRCA2 carriers who were diagnosed with breast cancer between 1995 and 2019.

Key Takeaways:

  • Uptake of BSO was significantly lower among Black and Asian versus White women, with odds ratios of 0.48 and 0.47, respectively.
  • Women living in the least socioeconomically deprived areas had higher BSO uptake, with an odds ratio of 1.38 compared to the most deprived areas.
  • For both BRCA1 and BRCA2 pathogenic variant carriers, BSO was associated with a reduced risk of all-cause mortality, with a hazard ratio of 0.52.
  • BSO was also associated with reduced breast cancer-specific mortality in both BRCA1 and BRCA2 carriers, with hazard ratios of 0.62 and 0.48, respectively.
  • In the combined BRCA1 and BRCA2 sample, BSO was associated with a reduced risk of a second non-breast cancer, with a hazard ratio of 0.59.
  • BSO was not associated with an increased risk for cardiovascular diseases, ischemic heart disease, cerebrovascular disease, non-breast cancer-specific mortality, contralateral breast cancer, or depression.

Statistics:

  • 1,674 BRCA1, 1,740 BRCA2, and nine BRCA1 and BRCA2 carriers were included in the study, representing a total of 3,423 women.
  • The study used data from the National Cancer Registration Dataset and the Hospital Episode Statistics-Admitted Patient Care dataset.
  • The study found that BSO uptake was significantly lower among Black and Asian versus White women, with odds ratios of 0.48 and 0.47, respectively.
  • Women living in the least socioeconomically deprived areas had higher BSO uptake, with an odds ratio of 1.38 compared to the most deprived areas.

Sources:

  • Hassan et al., "Bilateral salpingo-oophorectomy and long-term health outcomes in women with a personal history of breast cancer and a BRCA1 or BRCA2 pathogenic variant," The Lancet Oncology, online May 7, 2025.
  • University of Cambridge press release, "Bilateral salpingo-oophorectomy reduces mortality risk in BRCA carriers," May 7, 2025.