TY - JOUR
T1 - Impact of breast cancer history on decision-making for ovarian cancer risk-reducing surgery in the TUBA-WISP-II study
AU - Gootzen, Tamar A
AU - Steenbeek, Miranda P
AU - van Gelder, Marleen M H J
AU - van Bommel, Majke H D
AU - Timmer-Bonte, Anja J N H
AU - Kets, C Marleen
AU - Nitecki-Wilke, Roni
AU - Swisher, Elizabeth M
AU - Norquist, Barbara M
AU - Lu, Karen H
AU - Hermens, Rosella P M G
AU - de Hullu, Joanne A
AU - Zweemer, Ronald
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/12
Y1 - 2025/12
N2 - BACKGROUND: Female BRCA1/2 pathogenic variant carriers have an increased risk of breast and ovarian cancer. In the TUBA-WISP II study, women chose between standard risk-reducing salpingo-oophorectomy and risk-reducing salpingectomy with delayed oophorectomy to prevent ovarian cancer. At inclusion, a substantial proportion of the enrolled women had a history of breast cancer, which could affect decision-making.OBJECTIVE: This study aimed to describe decision-making regarding the type and timing of risk-reducing surgery between women with and without a history of breast cancer.STUDY DESIGN: Premenopausal BRCA1/2 pathogenic variant carriers completed Web-based questionnaires on their personal histories and preferred risk-reducing strategy. Differences in the type and timing of the first risk-reducing surgery between women with and without a history of breast cancer were assessed. A multivariate analysis was performed to examine personal, environmental, and breast cancer-related characteristics associated with the choice of risk-reducing salpingo-oophorectomy among women with a history of breast cancer.RESULTS: This study included 1676 women, among whom 222 (13.2%) had a history of breast cancer. Of note, 77.0% of women with a history of breast cancer chose risk-reducing salpingectomy with delayed oophorectomy compared with 78.0% of women without a history of breast cancer (P=.73). Individuals with breast cancer before their BRCA1/2 diagnosis had their first surgery at a median of 2 years later than those who were diagnosed simultaneously or had their BRCA1/2 diagnosis first. Women diagnosed with breast cancer within the guideline age range for completing risk-reducing salpingo-oophorectomy (35-40 years for BRCA1 and 40-45 years for BRCA2) more often chose risk-reducing salpingo-oophorectomy than those before the guideline age range (odds ratio, 6.2 [95% confidence interval, 1.9-19.9]).CONCLUSION: A history of breast cancer was not associated with a preference for a specific risk-reducing strategy. Women diagnosed with breast cancer within the guideline age range more often chose risk-reducing salpingo-oophorectomy than those diagnosed with breast cancer before the guideline age range.
AB - BACKGROUND: Female BRCA1/2 pathogenic variant carriers have an increased risk of breast and ovarian cancer. In the TUBA-WISP II study, women chose between standard risk-reducing salpingo-oophorectomy and risk-reducing salpingectomy with delayed oophorectomy to prevent ovarian cancer. At inclusion, a substantial proportion of the enrolled women had a history of breast cancer, which could affect decision-making.OBJECTIVE: This study aimed to describe decision-making regarding the type and timing of risk-reducing surgery between women with and without a history of breast cancer.STUDY DESIGN: Premenopausal BRCA1/2 pathogenic variant carriers completed Web-based questionnaires on their personal histories and preferred risk-reducing strategy. Differences in the type and timing of the first risk-reducing surgery between women with and without a history of breast cancer were assessed. A multivariate analysis was performed to examine personal, environmental, and breast cancer-related characteristics associated with the choice of risk-reducing salpingo-oophorectomy among women with a history of breast cancer.RESULTS: This study included 1676 women, among whom 222 (13.2%) had a history of breast cancer. Of note, 77.0% of women with a history of breast cancer chose risk-reducing salpingectomy with delayed oophorectomy compared with 78.0% of women without a history of breast cancer (P=.73). Individuals with breast cancer before their BRCA1/2 diagnosis had their first surgery at a median of 2 years later than those who were diagnosed simultaneously or had their BRCA1/2 diagnosis first. Women diagnosed with breast cancer within the guideline age range for completing risk-reducing salpingo-oophorectomy (35-40 years for BRCA1 and 40-45 years for BRCA2) more often chose risk-reducing salpingo-oophorectomy than those before the guideline age range (odds ratio, 6.2 [95% confidence interval, 1.9-19.9]).CONCLUSION: A history of breast cancer was not associated with a preference for a specific risk-reducing strategy. Women diagnosed with breast cancer within the guideline age range more often chose risk-reducing salpingo-oophorectomy than those diagnosed with breast cancer before the guideline age range.
KW - Adult
KW - BRCA1 Protein/genetics
KW - BRCA2 Protein/genetics
KW - Breast Neoplasms/genetics
KW - Decision Making
KW - Female
KW - Genes, BRCA1
KW - Genes, BRCA2
KW - Humans
KW - Middle Aged
KW - Ovarian Neoplasms/prevention & control
KW - Ovariectomy
KW - Prophylactic Surgical Procedures
KW - Risk Reduction Behavior
KW - Salpingectomy
KW - Salpingo-oophorectomy
KW - Surveys and Questionnaires
U2 - 10.1016/j.ajog.2025.06.024
DO - 10.1016/j.ajog.2025.06.024
M3 - Article
C2 - 40532962
SN - 0002-9378
VL - 233
SP - 638.e1-638.e13
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 6
ER -