{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:55:32Z","timestamp":1790034932662,"version":"4.0.1"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec id=\"ab-soi230069-4\"><jats:title>Importance<\/jats:title><jats:p>Few studies have investigated whether prophylactic salpingo-oophorectomy (PSO) for patients with previously resected breast cancer who carry pathogenic germline <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> variants is associated with a reduced risk of cancer-specific death.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-5\"><jats:title>Objective<\/jats:title><jats:p>To assess the association of PSO and prophylactic mastectomy (PM) with prognosis after quadrantectomy or mastectomy as primary treatment for patients with <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> breast cancer.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study was performed in a single-institution, tertiary referral center. Consecutive patients with invasive breast cancer treated surgically between 1972 and 2019 were recruited and followed up prospectively after they were found to carry the <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> gene variant. The data analysis was performed between April 2022 and July 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-7\"><jats:title>Exposure<\/jats:title><jats:p>Following breast surgery, some patients underwent PSO, PM, or both, whereas others did not.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary study end point was overall survival as measured by the Kaplan-Meier method. Secondary end points were crude cumulative incidence of breast cancer\u2013specific mortality, ipsilateral breast tumor recurrence (IBTR), contralateral breast cancer, ovarian cancer, and ovarian cancer\u2013specific mortality.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-9\"><jats:title>Results<\/jats:title><jats:p>Of 480 patients included in the cohort (median age at initial surgery, 40.0 years; IQR, 34.0-46.0 years), PSO was associated with a significantly reduced risk of death (hazard ratio [HR], 0.40; 95% CI, 0.25-0.64; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). This reduction was most evident for patients carrying the <jats:italic>BRCA1<\/jats:italic> variant (HR, 0.35; 95% CI, 0.20-0.63; <jats:italic>P<\/jats:italic>\u2009=\u2009.001), those with triple-negative disease (HR, 0.21; 95% CI, 0.09-0.46; <jats:italic>P<\/jats:italic>\u2009=\u2009.002), and those with invasive ductal carcinoma (HR, 0.51; 95% CI, 0.31-0.84; <jats:italic>P<\/jats:italic>\u2009=\u2009.008). Prophylactic salpingo-oophorectomy was not associated with risk of contralateral breast cancer or IBTR. Initial or delayed PM was associated with a reduced risk of IBTR but not with overall survival or breast cancer\u2013specific mortality.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230069-10\"><jats:title>Conclusions<\/jats:title><jats:p>The study findings suggest that PSO should be offered to all patients with <jats:italic>BRCA1\/2<\/jats:italic> breast cancer who undergo surgery with curative intent to reduce risk of death. In particular, PSO should be offered to patients with the <jats:italic>BRCA1<\/jats:italic> variant at the time of breast surgery.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2023.4770","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T15:02:17Z","timestamp":1696431737000},"page":"1275","source":"Crossref","is-referenced-by-count":10,"title":["Prophylactic Salpingo-Oophorectomy and Survival After <i>BRCA1\/2<\/i> Breast Cancer Resection"],"prefix":"10.1001","volume":"158","author":[{"given":"Gabriele","family":"Martelli","sequence":"first","affiliation":[{"name":"Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Barretta","sequence":"additional","affiliation":[{"name":"Department of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Vernieri","sequence":"additional","affiliation":[{"name":"Breast Unit, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"},{"name":"IFOM ETS, the AIRC Foundation of Molecular Oncology, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Secondo","family":"Folli","sequence":"additional","affiliation":[{"name":"Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Pruneri","sequence":"additional","affiliation":[{"name":"Breast Unit, Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"},{"name":"Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Segattini","sequence":"additional","affiliation":[{"name":"Unit of Breast Surgery, University Hospital, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Trapani","sequence":"additional","affiliation":[{"name":"Unit of Surgical Oncology, Humanitas Institute, Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Carolla","sequence":"additional","affiliation":[{"name":"Department of Surgical and Oncological Sciences, Policlinico P. 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