29 januari 2009: Bron: Medscape en J Natl Cancer Inst. 2009;101:70-71, 80-87.

Vrouwen die drager zijn van het BRCA1 of BRCA2 gen en daardoor een vergroot risico lopen op het krijgen van borstkanker en eierstokkanker kunnen dit risico beperken door hun eierstokken en eileiders weg te laten halen. Het risico vermindert met minimaal 50% voor borstkanker en 80% voor eierstokkanker. Dit blijkt uit een meta-analyse van een aantal gerandomiseerde grootschalige onderzoeken. Hieronder een aantal citaten uit een artikel uit Medscape dat deze studie van commentaar voorziet met de resultaten uit de gezamenlijke studies.

January 14, 2008 — Prophylactic salpingo-oophorectomy, or the surgical removal of the ovaries and fallopian tubes, reduces the risk for breast cancer by 50% and the risk for ovarian and fallopian tube cancer by 80% in women who carry mutations in the BRCA1 or BRCA2 gene, according to a new meta-analysis.

"It's really very clear that this surgery is protective. That's not controversial anymore. Our study quantifies the cancer risk reduction and is the most authoritative review to date," said Timothy R. Rebbeck, PhD, professor of epidemiology at the University of Pennsylvania School of Medicine, in Philadelphia, in an interview with Medscape Oncology.
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. "We urge providers of cancer genetics counseling services to adopt the summary risk estimates developed by Rebbeck et al. as those most currently reliable when counseling BRCA mutation carriers."
However, Dr. Rebbeck reminded clinicians that the surgery is "risk-reducing and not 100% risk-eliminating," and that other prevention options might also be needed to address residual cancer risk.
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An Attempt to Differentiate Risk for BRCA1 vs BRCA2
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One of the most commendable features of the current meta-analysis is that Dr. Rebbeck and colleagues "attempted to disentangle potential differences between BRCA1 and BRCA2 mutation carriers," write the editorialists. The 2 have important biologic differences that make a combined analysis "suboptimal."
Dr. Rebbeck and colleagues found a total of 10 studies that investigated breast or gynecologic cancer outcomes in BRCA1/2 mutation carriers who had undergone prophylactic salpingo-oophorectomy.
Breast cancer outcomes were investigated in 3 nonoverlapping studies of BRCA1/2 mutation carriers, 4 of BRCA1 mutation carriers, and 3 of BRCA2 mutation carriers. Gynecologic cancer outcomes were investigated in 3 nonoverlapping studies of BRCA1/2 mutation carriers and 1 study of BRCA1 mutation carriers.
Prophylactic salpingo-oophorectomy was associated with a statistically significant reduction in risk for breast cancer in BRCA1/2 mutation carriers (hazard ratio , 0.49; 95% confidence interval , 0.37 - 0.65). Similar risk reductions were observed in BRCA1 mutation carriers (HR, 0.47; 95% CI, 0.35 - 0.64) and in BRCA2 mutation carriers (HR, 0.47; 95% CI, 0.26 - 0.84).
Prophylactic salpingo-oophorectomy was also associated with a statistically significant reduction in the risk for BRCA1/2-associated ovarian or fallopian tube cancer (HR, 0.21; 95% CI, 0.12 - 0.39). Data were insufficient to obtain separate estimates for ovarian or fallopian tube cancer risk reduction with prophylactic salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers.
 
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