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The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population\u2010base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (<jats:italic>n<\/jats:italic> = 21,067). We fitted flexible parametric breast cancer\u2010specific and overall survival models with 95% confidence intervals (also known as Royston\u2013Parmar models) to assess the impact of risk\u2010reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20\u201349 and 50\u201379 years, respectively. Overall, 1,426 women (7%) underwent risk\u2010reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk\u2010reducing surgery compared to 171 who did not have risk\u2010reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall [adjusted hazard ration (HR), 0.69; 95% confidence interval (CI), 0.53\u20130.89; <jats:italic>p<\/jats:italic> = 0.005]. Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45; 95% CI, 0.25\u20130.79; <jats:italic>p<\/jats:italic> &lt; 0.006). This was largely driven by reduction in breast cancer\u2010specific mortality (HR, 0.43; 95% CI, 0.24\u20130.79; <jats:italic>p<\/jats:italic> &lt; 0.006). This population\u2010based study found that risk\u2010reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts and subsequently randomised trials are needed to confirm these findings.<\/jats:p>","DOI":"10.1002\/ijc.28537","type":"journal-article","created":{"date-parts":[[2013,10,14]],"date-time":"2013-10-14T11:54:41Z","timestamp":1381751681000},"page":"2211-2222","source":"Crossref","is-referenced-by-count":21,"title":["The impact of risk\u2010reducing hysterectomy and bilateral salpingo\u2010oophorectomy on survival in patients with a history of breast cancer\u2014A population\u2010based data linkage study"],"prefix":"10.1002","volume":"134","author":[{"given":"Andreas","family":"Obermair","sequence":"first","affiliation":[{"name":"Queensland Centre for Gynaecological Cancer School of Medicine The University of Queensland, Royal Brisbane and Women's Hospital Brisbane, QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny R.","family":"Youlden","sequence":"additional","affiliation":[{"name":"Cancer Council Queensland Brisbane, QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Baade","sequence":"additional","affiliation":[{"name":"Cancer Council Queensland Brisbane, QLD Australia"},{"name":"School of Public Health Queensland University of Technology Brisbane, QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Janda","sequence":"additional","affiliation":[{"name":"School of Public Health Queensland University of Technology Brisbane, QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,31]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Cancer IAfRi.Globocan cancer fact sheet: breast cancer vol. 2013. 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