Eva Blondeaux1, Amir Sonnenblick, Elisa Agostinetto et al. Lancet Oncol. 2025 26(6):759-770
We investigated the association between risk-reducing mastectomy (RRM) or risk-reducing salpingo-oophorectomy (RRSO), or both procedures, with survival outcomes in a large global cohort of young BRCA carriers with previous breast cancer. Between Jan 1, 2000, and Dec 31, 2020, 5290 patients were included, of whom 3361 (63·5%) patients were BRCA1 pathogenic variant carriers, 2708 (51·2%) had node-negative, and 2421 (45·8%) hormone receptor-positive breast cancer. Of 5290 patients, 2910 (55·0%) underwent RRM, 2782 (52·6%) underwent RRSO. After a median follow-up of 8·2 years, RRM was associated with significantly better overall survival compared with no RRM (adjusted HR [aHR] 0·65; 20-year restricted mean overall survival time 17·89 years with RRM vs 16·65 years without RRM). RRSO was also associated with significantly better overall survival compared with no RRSO (aHR 0·58; 20-year restricted mean overall survival time 17·73 years with RRSO vs 16·67 years without RRSO). In this global cohort of BRCA carriers with previous breast cancer diagnosis at a young age, RRM and RRSO were both associated with a significant improvement in overall survival. These findings provide evidence for a tailored counselling of a unique and high-risk patient population on cancer risk management strategies.
24 Mar, 2026