Women who have been diagnosed with breast cancer carrying specific BRCA1 and BRCA2 genetic variants offered surgery to remove ovarian and trumpets, as this dramatically reduces the risk of ovarian cancer.
Now, Cambridge researchers have shown that this process-known as a bilateral Salpingo-Ootomeporectomy (BSO)-is associated with a significant reduction in the risk of early death among these women, without serious side effects.
Women with certain variations of BRCA1 and BRCA2 genes have a high risk of developing ovarian and breast cancer. These women are recommended to remove the ovaries and their fallopian tubes at a relatively young age – between the ages of 35 and 40 for BRCA1 carriers and between the ages of 40 and 45 for BRCA2 carriers.
Previously, BSO has been shown to lead to a 80% reduction in the risk of developing ovarian cancer among these women, but there is concern that there may be unintentional consequences as a result of the main source of estrogen, which causes early menopause. This can be particularly difficult for BRCA1 and BRCA2 carriers with a history of breast cancer, as they may not receive typical hormone replacement therapy to manage symptoms. The overall impact of BSO on BRCA1 and BRCA2 carriers with a previous history of breast cancer remains uncertain.
Usually, researchers will evaluate the benefits and dangers associated with BSO through randomized testing tests, the “gold standard” to test how well the treatments work. However, to do so for women who carry BRCA1 and BRCA2 variants would be unethical, as they would have a great deal of greater risk of developing ovarian cancer.
To work around this problem, a team at the University of Cambridge, in collaboration with the National Disease Registration Service (NDRS) in NHS England, was transformed into electronic health files and data from NHS Genetic Testing Laboratories collected and curated by NDRS to examine BSO’s long -term BSO results between BSO between BSO BRCA1 and BRCA2 PV with breast cancer. The results of their study, the first large -scale study of this kind, are published today The oncology Lancet.
The group recognized a total of 3,400 women carrying one of the variants that cause BRCA1 and BRCA2 cancer (about 1,700 women for each variant). About 850 of the BRCA1 carriers and 1,000 of the BRCA2 carriers had undergone BSO surgery.
BSO women were about half a chance of dying of cancer or any other cause during the follow -up period (5.5 years of monitoring time). This reduction was more intense on BRCA2 carriers compared to BRCA1 bodies (56% reduction compared to 38% respectively). These women were also about 40% lower risk of developing a second cancer.
Although the team says it is impossible to say with 100% certainty that BSO is causing this risk reduction, they argue that data is strongly shown to this conclusion.
It is important that researchers have found no relationship between BSO and increased risk of other long -term effects such as heart disease and stroke or depression. This contradicts previous studies that have found elements in the general population of a correlation between BSO and the increased risk of these conditions.
The first writer Hend Hassan, a PhD student at the Cancer Epidemiology Center, the Department of Public Health and Primary Care, and the Wolfson College, Cambridge, said: “We know that the removal of ovarian and palloparas Non -enhanced consequences that may arise from the sudden appearance of the menu this cause.
“Reassuringly, our research has shown that for women with personal history of breast cancer, this process offers clear benefits for survival and lower risk of other cancers without adverse side effects such as heart disease or depression.”
Most of the women who underwent BSO were white. Black and Asian women were about half a chance of having BSO compared to white women. Women living in less degraded areas were more likely to have BSO compared to those of the closest class.
Hassan added: “Given the clear benefits of this women’s process at risk, it is that some groups of women are less likely to undergo.
Our findings will be vital to advice to women with cancer associated with one of the BRCA1 and BRCA2 variants, allowing them to make documented decisions on whether or not they choose this feature. “
Professor Antonis Antoniou, senior author of the study, Department of Public Health and Primary Care
Professor Antoniou, who is also director of the Cancer Data Detection Program, added: “The study also highlights the power of excellent NHS data sets in offensive, clinically relevant research.”
The survey was funded by the Cancer Research UK, with additional support from the Biomedical Research Center of the National Institute of Health and Care (NIHR).
Source:
Magazine report:
Hassan, H., et al. (2025). The long-term health effects of bilateral Salpingo-Oohorectomy in BRCA1 and BRCA2 Pathogenic variants with personal history of breast cancer: a retrospective coach study using connected electronic health files. The oncology Lancet. Doi.org/10.1016/S1470-2045(25)).
