Survival Outcomes With or Without Risk-Reducing Mastectomy in BRCA1 and BRCA2 Pathogenic Variant Carriers

BRCA1, BRCA2

Regional prospective cohort (Manchester, UK) of 1,205 pvBRCA1/2 women: 460 BRRM vs 745 surveillance. Analysis of cancer incidence and survival over 4,652 woman-years post-BRRM.

Regional prospective cohort (Manchester, UK) of 1,205 pvBRCA1/2 women comparing bilateral risk-reducing mastectomy (BRRM, n=460) to imaging surveillance (n=745) over 4,652 woman-years post-BRRM. Annual breast cancer incidence is reduced from 2.4% to 0.15% after BRRM (–94%, p<0.001). However, breast cancer-specific deaths are similar in both groups (2 vs 4 deaths, p=0.36). 9 occult cancers (2%) were found at surgery.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

Clinically crucial message: BRRM massively reduces incidence but does not demonstrate a survival advantage in this follow-up. This result must be integrated into genetic counseling: women who prefer surveillance do not have significantly worse survival. Reinforces shared decision-making rather than a directive recommendation.

prospective cohort +2; nuanced clinical message (incidence vs mortality) +2; JCO +1; n=1,205 +1; shared decision-making +1