Systematic review and meta-analysis of association of risk-reducing bilateral mastectomy with mortality in carriers of BRCA1/2 variants

Risk-reducing bilateral mastectomy (RRBM) reduces the incidence of breast cancer in female carriers of the BRCA1 and BRCA2 pathogenic variants, but its association with mortality is not clear. Systematic review and meta-analysis of 6 observational studies, including 6135 female carriers of the BRCA1/2 variants, demonstrated that RRBM was associated with a decrease in overall mortality (HR 0.37; p<0.001) and breast cancer-specific mortality (HR0.14; p=0.002), compared with not undergoing the procedure. The authors conclude that these results suggest that a mortality benefit of RRBM should be considered in the shared decision-making conversations with female carriers of BRCA1 and BRCA2 pathogenic variants.