Surgical Intervention May Improve Survival in Young Patients with Breast Cancer

Among patients aged 40 years or younger with breast cancer and the BRCA gene, risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO) have been shown to significantly improve overall survival (OS), disease-free survival (DFS), and breast cancer-free interval (BCFI). This was revealed in findings presented at the 2024 San Antonio Breast Cancer Symposium (SABCS).

The study included 5,290 patients from 33 countries, with a median follow-up of 8.2 years. It found that patients who underwent RRM had a 42% reduced risk for DFS and a 45% reduced risk for events, regardless of BRCA gene, age at diagnosis, tumor subtype, tumor size, and nodal status. OS events were also reduced by 35%.

For those who underwent RRSO, there was a 35% reduction in the risk of BCFI events and a 32% reduction in the risk of DFS events. These patients also experienced a 42% reduced risk of OS events, irrespective of age at diagnosis, tumor size, and nodal status. The study highlighted significant interactions with tumor subtype, showing a 57% risk reduction for triple-negative breast cancer and a 20% reduction for hormone receptor-positive breast cancer.

Dr. Matteo Lambertini, associate professor and consultant in medical oncology at the University of Genova – IRCCS Policlinico San Martino Hospital in Genova, Italy, emphasized the importance of these findings for counseling BRCA carriers with young-onset breast cancer on cancer-risk management strategies. However, he noted that these results should not be used to counsel BRCA healthy carriers or BRCA carriers diagnosed with breast cancer at an older age.

The study provides the first global evidence that risk-reducing surgeries improve survival outcomes among young BRCA mutation carriers with a prior history of early-onset breast cancer, marking a significant step forward in the management of cancer risk for these patients.