Multinational longitudinal cohort study of the association of bilateral oophorectomy and all-cause mortality in women with BRCA1/2 pathogenic variants

Preventive bilateral salpingo-oophorectomy is offered to women at high risk of ovarian cancer who carry a pathogenic variant (PV) in BRCA1 or BRCA2. However, the association of bilateral oophorectomy with all-cause mortality has not been clearly defined. In a multinational longitudinal cohort study of 4332 women with a mean follow-up of 9.0 years, 901 incident cancers were noted in 851 women and 228 women had died (57 of ovarian or fallopian tube cancer, 58 of breast cancer, 16 of peritoneal cancer, and 97 of other causes). The age-adjusted hazard ratio was 0.32 for all-cause mortality associated with preventive bilateral oophorectomy, 0.28 for women with BRCA1 PVs, and 0.43 for women with BRCA2 PVs. The authors conclude that among women with BRCA1/2 PVs, bilateral oophorectomy was associated with a significant reduction in all-cause mortality.