Evidence map›Paper›PMID 40347973›Full record

ArticleThe Lancet. Oncology2025

Association between risk-reducing surgeries and survival in young BRCA carriers with breast cancer: an international cohort study.

Eva Blondeaux, Amir Sonnenblick, Elisa Agostinetto, Raphaëlle Bas, Hee J Kim, Maria A Franzoi, Rinat Bernstein-Molho, Sabine Linn, Ava Kwong, Katarzyna Pogoda and 39 more

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in The Lancet. Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03673306 (A Multicenter Retrospective Study on the Prognostic Impact of Pregnancy in Women With History of BRCA Mutated Breast Cancer), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03673306 completednot on this map

A Multicenter Retrospective Study on the Prognostic Impact of Pregnancy in Women With History of BRCA Mutated Breast Cancer

TypeobservationalSponsorJules Bordet InstituteRan2017 to 2023Enrolled4,732ConditionsBreast CancerArmsClinical outcomes
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Trial
  4. Article
  5. Review
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  9. Article
  10. The Potential Role of Vitamin D inInternational journal of molecular sciences · 2026
    Review
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  15. Article
  16. Risk-Reducing Mastectomy inJournal of breast cancer · 2026
    Review
  17. Article
  18. Article
  19. Review
  20. GermlinePathology oncology research : POR · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

49 authors.

Eva BlondeauxClinical Trial Unit, Epidemiologia Clinica, Ospedale Policlinico San Martino, Genova, Italy.
Amir SonnenblickThe Oncology Division, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Elisa AgostinettoUniversité libre de Bruxelles, Hôpital Universitaire de Bruxelles, Institut Jules Bordet, Service de Oncologie, Brussels, Belgium.
Raphaëlle BasDepartment of Medical Oncology, Universite Paris Cité, Institut Curie, Paris, France.
Hee J KimDivision of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Maria A FranzoiCancer Survivorship Group, Gustave Roussy, Villejuif, France; INSERM U981, Villejuif, France.
Rinat Bernstein-MolhoSusanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center affiliated to Tel Aviv University, Tel Hashomer, Israel.
Sabine LinnDepartment of Medical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands.
Ava KwongHong Kong Hereditary Breast Cancer Family Registry, Hong Kong; Cancer Genetics Centre and Breast Surgery Centre, Hong Kong Sanatorium and Hospital, Hong Kong; Department of Surgery, The University of Hong Kong, Hong Kong.
Katarzyna PogodaDepartment of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Judith BalmanaHereditary Cancer Genetics Unit, Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
Ann SmeetsDepartment of Surgical Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Jyoti BajpaiTata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Halle C F MooreCleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA; Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA.
Ann H PartridgeDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Kelly-Anne PhillipsDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
Angela TossDepartment of Oncology and Haematology, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy; Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Christine Rousset-JablonskiDepartment of Surgery, Leon Berard Cancer Center, Lyon, France; INSERM 1290 RESHAPE, Lyon, France; Hôpital Femme Mère Enfant, Bron, France.
Fedro A PeccatoriGynecologic Oncology Department, European Institute of Oncology, Milan, Italy.
Tiphaine RenaudCancer Genetics Unit, Bergonie Institute, Bordeaux, France.
Alberta FerrariHereditary Breast and Ovarian Cancer Unit and General Surgery 3-Senology, Breast Cancer Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; University of Pavia, Pavia, Italy.
Shani Paluch-ShimonSharett Institute of Oncology, Hadassah University Hospital and Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Pablo MandoSUMA Argentina.
Jeong E LeeSungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
Robert FruscioUO Gynecology, IRCCS San Gerardo dei Tintori, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
Wanda CuiDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
Stephanie M WongDepartment of Surgery and Oncology, Jewish General Hospital Segal Cancer Centre, Montreal, QC, Canada.
Claudio VernieriMedical Oncology Department, Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Oncology and Hematology-Oncology Department, University of Milan, Milan, Italy.
Kathryn J RuddyDepartment of Oncology, Mayo Clinic, Rochester, MN, USA.
Maria V DieciDipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università di Padova, Padova, Italy; Oncologia 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
Alexios MatikasDepartment of Oncology-Pathology, Karolinska Institute and Breast Center, Karolinska University Hospital, Stockholm, Sweden.
Mariya RozenblitYale University, Medical Oncology, Yale New Haven, CT, USA.
Deniz C GuvenHacettepe University Cancer Institute, Ankara, Turkey.
Minna LeeBreast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Cynthia Villarreal-GarzaBreast Cancer Center, Hospital Zambrano Hellion -TecSalud, Tecnologico de Monterrey, Monterrey, Mexico.
Shelley E HwangDepartment of Surgery, Duke University, Durham, NC, USA.
Laura De MarchisDivision of Medical Oncology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy; Medical Oncology Unit Department of Hematology, Oncology, Dermatology Umberto I University Hospital, Rome, Italy.
Fabio PuglisiDepartment of Medical Oncology, Centro di Riferimento Oncologico di Avano-CRO IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy.
Zoe KempBreast Medical Oncology and Cancer Genetics Units, Royal Marsden Hospital, London, UK.
Pedro A MeirelesMedical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
Anastasia ParokonnayaNational Medical Research Center of Oncology named after N N Blokhin of the Russian Ministry of Health, Moscow, Russia.
Gustavo WerutskyHospital Moinhos de Vento, Porto Alegre, Brazil.
Maiko OkanoHoshi General Hospital, Koriyama, Japan; Fukushima Medical University, Fukushima, Japan.
Hatem A AzimCairo Cure Oncology Center, Cairo, Egypt.
Kleida MatiSALUS Hospital, Tirana, Albania.
Shoshana RosenbergDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Richard GelberDivision of Biostatistics, Dana-Farber Cancer Institute, Boston, MA, USA.
Luca BoniClinical Trial Unit, Epidemiologia Clinica, Ospedale Policlinico San Martino, Genova, Italy.
Matteo LambertiniDepartment of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy. Electronic address: matteo.lambertini@unige.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle evidence exists on the effect of risk-reducing surgeries in young BRCA carriers with a previous history of breast cancer. 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.

methodsThe BRCA BCY Collaboration is an international, hospital-based, retrospective cohort study, conducted at 109 centres in five continents, including women harbouring germline BRCA1, BRCA2, or both, pathogenic or likely pathogenic variants and diagnosed with stage I-III invasive breast cancer at the age of 40 years or younger between Jan 1, 2000, and Dec 31, 2020. The primary objectives of the present analysis were to determine the association between RRM or RRSO and overall survival in young BRCA carriers with breast cancer. The primary endpoint was overall survival. This study is registered with ClinicalTrials.gov, NCT03673306.

findingsBetween 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 (IQR 4·7-12·8), RRM was associated with significantly better overall survival compared with no RRM (adjusted HR [aHR] 0·65, 95% CI 0·53-0·78; 20-year restricted mean overall survival time 17·89 years [95% CI 17·61-18·17] with RRM vs 16·65 years [16·38-16·92] without RRM). RRSO was also associated with significantly better overall survival compared with no RRSO (aHR 0·58, 95% CI 0·48-0·71; 20-year restricted mean overall survival time 17·73 years [95% CI 17·43-18·03] with RRSO vs 16·67 years [16·38-16·96] without RRSO).

interpretationIn 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.

fundingItalian Association for Cancer Research.

Indexed as

BRCA1 ProteinBRCA2 ProteinBreast NeoplasmsProphylactic MastectomySalpingo-oophorectomyAdultFemaleGenetic Predisposition to DiseaseGerm-Line MutationHeterozygoteHumansRetrospective StudiesBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, human

Identifiers

PMID40347973

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