{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:35:35Z","timestamp":1793414135305,"version":"4.5.0"},"reference-count":47,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"10","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      Many women carrying pathogenic variants (pvs) of\n                      <jats:italic toggle=\"yes\">BRCA1<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">BRCA2<\/jats:italic>\n                      genes (pv\n                      <jats:italic toggle=\"yes\">BRCA<\/jats:italic>\n                      <jats:italic toggle=\"yes\">1\/2<\/jats:italic>\n                      ) elect to undergo bilateral risk-reducing mastectomy (BRRM) in the belief that it will improve their overall survival (OS). Although many are satisfied with their decision to undergo BRRM a significant minority exhibit regret. We compared long-term oncology outcomes in women with pv\n                      <jats:italic toggle=\"yes\">BRCA1\/2<\/jats:italic>\n                      choosing BRRM with those choosing a program of imaging surveillance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      All participants were attendees at a regional family history\/genetics service and had undergone genetic testing for pv\n                      <jats:italic toggle=\"yes\">BRCA<\/jats:italic>\n                      <jats:italic toggle=\"yes\">1\/2<\/jats:italic>\n                      . Carriers of pv\n                      <jats:italic toggle=\"yes\">BRCA1\/2<\/jats:italic>\n                      elected either to undergo BRRM or imaging surveillance as directed by UK national guidance. A prospective cohort design examined OS, breast cancer\u2013specific death, and breast cancer incidence between the study groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 460 women elected to undergo BRRM, while 745 chose surveillance (median age, 37.2 years and 38.5 years, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .06). Follow-up totaled 4,652 woman-years after BRRM. Overall annual incidence rate of breast cancer was 2.4%, falling to 0.15% after BRRM, a 94% reduction compared with surveillance alone (log-rank chi-square = 86.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). There were nine occult cancers diagnosed at BRRM (2%). Breast cancer\u2013specific deaths were similar in the BRRM and surveillance groups (two and four deaths, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .36; 4,634 and 5,419 woman-years of follow-up, respectively). Proportionately, deaths from breast cancer were similar to deaths from ovarian cancer in both treatment groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      For women electing imaging surveillance over risk-reducing surgery, our results may offer reassurance that their breast cancer\u2013specific survival and OS are unlikely to be compromised. However, breast cancer incidence rates are significantly reduced after BRRM compared with imaging surveillance, which may be important information for women with pv\n                      <jats:italic toggle=\"yes\">BRCA<\/jats:italic>\n                      <jats:italic toggle=\"yes\">1\/2<\/jats:italic>\n                      considering BRRM.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-00834","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T21:00:10Z","timestamp":1770238810000},"page":"874-882","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":8,"title":["Survival Outcomes With or Without Risk-Reducing Mastectomy in\n                    <i>BRCA1<\/i>\n                    and\n                    <i>BRCA2<\/i>\n                    Pathogenic Variant Carriers"],"prefix":"10.1200","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7264-6201","authenticated-orcid":true,"given":"Ashu","family":"Gandhi","sequence":"first","affiliation":[{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine &amp; Health, University of Manchester, Manchester, United Kingdom"},{"name":"Manchester University Hospitals, Manchester, United Kingdom"},{"name":"Manchester Academic Health Sciences Centre &amp; Manchester Breast Centre, University of Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-6515","authenticated-orcid":true,"given":"Sacha J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine &amp; Health, University of Manchester, Manchester, United Kingdom"},{"name":"Manchester University Hospitals, Manchester, United Kingdom"},{"name":"Manchester Academic Health Sciences Centre &amp; Manchester Breast Centre, University of Manchester, Manchester, United Kingdom"},{"name":"Christie Hospital NHS Foundation Trust, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-7739","authenticated-orcid":true,"given":"Elaine F.","family":"Harkness","sequence":"additional","affiliation":[{"name":"Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-2855","authenticated-orcid":true,"given":"Emma","family":"Woodward","sequence":"additional","affiliation":[{"name":"Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-8377","authenticated-orcid":true,"given":"Fiona","family":"Lalloo","sequence":"additional","affiliation":[{"name":"Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8035-4471","authenticated-orcid":true,"given":"Claire","family":"Forde","sequence":"additional","affiliation":[{"name":"Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Harvey","sequence":"additional","affiliation":[{"name":"Manchester University Hospitals, Manchester, United Kingdom"},{"name":"Manchester Academic Health Sciences Centre &amp; Manchester Breast Centre, University of Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsey","family":"Highton","sequence":"additional","affiliation":[{"name":"Manchester University Hospitals, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8900-0645","authenticated-orcid":true,"given":"Nicola","family":"Flaum","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine &amp; Health, University of Manchester, Manchester, United Kingdom"},{"name":"Christie Hospital NHS Foundation Trust, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-5784","authenticated-orcid":false,"given":"D. 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