Evidence map›Paper›PMID 40996624›Full record

ArticleAnnals of surgical oncology2026

Uptake of Risk Reducing Mastectomy in Older BRCA1/2 and PALB2 Carriers Undergoing Genetic Testing after 60 Years of Age.

Amel Melanson, Sarah Mashal, Carla Apostolova, Amina Ferroum, Mark Basik, Jean Francois Boileau, Karyne Martel, Sarkis Meterissian, Nora Wong, Evan Weber and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Breast cancer prevention in patients with gBRCA-mutated ovarian cancer.Journal of cancer research and clinical oncology · 2026
    Article
  3. Risk-Reducing Mastectomy inJournal of breast cancer · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Amel MelansonDepartment of Surgery, McGill University, Montreal, QC, Canada.
Sarah MashalDepartment of Surgery, McGill University, Montreal, QC, Canada.
Carla ApostolovaDepartment of Surgery, McGill University, Montreal, QC, Canada.
Amina FerroumDepartment of Surgery, McGill University, Montreal, QC, Canada.
Mark BasikDepartment of Surgery, McGill University, Montreal, QC, Canada.
Jean Francois BoileauDepartment of Surgery, McGill University, Montreal, QC, Canada.
Karyne MartelDepartment of Surgery, McGill University, Montreal, QC, Canada.
Sarkis MeterissianDepartment of Surgery, McGill University, Montreal, QC, Canada.
Nora WongStroll Cancer Prevention Centre, Jewish General Hospital, Montreal, QC, Canada.
Evan WeberDepartment of Human Genetics, McGill University, Montreal, QC, Canada.
William D FoulkesStroll Cancer Prevention Centre, Jewish General Hospital, Montreal, QC, Canada.
Ipshita PrakashDepartment of Surgery, McGill University, Montreal, QC, Canada.
Stephanie M WongDepartment of Surgery, McGill University, Montreal, QC, Canada. sm.wong@mcgill.ca.

Funding

Fonds de Recherche du Québec - Santé 309854
6 · The paper itself

Abstract

backgroundThe purpose of this study was to evaluate risk-reducing mastectomy (RRM) uptake in older BRCA1/2 and PALB2 carriers who undergo genetic testing after age 60 years.

methodsWe performed a multicentered retrospective cohort study of all female patients with a confirmed pathogenic variant in BRCA1/2 or PALB2 between 2003 and 2024. Women were categorized as having undergone genetic testing prior to or at/after 60 years of age, with clinical characteristics and risk management strategies compared between groups. Cox Proportional Hazards regression was then used to evaluate factors associated with RRM receipt.

resultsOf 814 BRCA1/2 and PALB2 carriers, 102 (12.5%) underwent genetic testing after age 60 years. At a median follow up of 56 months, 36 (35.3%) BRCA1/2 and PALB2 carriers tested over age 60 years underwent RRM. Uptake of RRM varied by personal history of breast cancer; in affected BRCA1/2 and PALB2 carriers, 47.6% of older patients underwent RRM compared with 78.9% of younger carriers (p < 0.001). In unaffected carriers, uptake of RRM was significantly lower among older patients (15.4% versus 40.3%, p = 0.008). In subgroup analysis of older carriers tested after age 60 years, factors associated with higher uptake of RRM included the presence of a BRCA1 or PALB2 variant (p < 0.005), personal history of breast cancer (p < 0.001), and no prior ovarian cancer (p = 0.005).

conclusionsAmong BRCA1/2 and PALB2 carriers tested over the age of 60 years, 47.6% of affected carriers and 15.4% of unaffected carriers elected to undergo RRM. Further research evaluating optimal risk-management strategies in older carriers is warranted.

Indexed as

BRCA1 ProteinBRCA2 ProteinBreast NeoplasmsFanconi Anemia Complementation Group N ProteinGenetic TestingMastectomyProphylactic MastectomyAdultAgedAge FactorsFemaleFollow-Up StudiesGenetic Predisposition to DiseaseHeterozygoteHumansMiddle AgedBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanFanconi Anemia Complementation Group N ProteinPALB2 protein, humanBRCA1/2Breast neoplasmsChemotherapyHereditary breast cancer

Identifiers

PMID40996624

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.