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2022-RA-1161-ESGO The impact of oophorectomy on survival from breast cancer in patients with CHEK2 mutations
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  1. Joanna Tomiczek-Szwiec1,
  2. Marek Szwiec2,
  3. Michał Falco3,
  4. Cezary Cybulski4,
  5. Dominika Wokolorczyk4,
  6. Anna Jakubowska4,
  7. Jacek Gronwald4,
  8. Małgorzata Stawicka5,
  9. Dariusz Godlewski6,
  10. Ewa Kilar7,
  11. Elżbieta Marczyk8,
  12. Monika Siołek9,
  13. Rafał Wiśniowski10,
  14. Olga Haus11,
  15. Robert Sibilski12,
  16. Lubomir Bodnar13,
  17. Ping Sun14,
  18. Steven A Narod14,
  19. Jan Lubinski4 and
  20. Tomasz Huzarski4
  1. 1Department of Oncological Gynecology, Dept Director Ewa Milnerowicz-Nabzdyk MD PhD Associate Prof., Oncological Center, Opole, Poland
  2. 2Department of Clinical Oncology, University Hospital, Zielona Góra, Poland
  3. 3Regional Oncology Hospital, Szczecin, Poland
  4. 4Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
  5. 5Department of Clinical Genetics and Pathology, University Hospital, Zielona Góra, Poland
  6. 6OPEN, Poznań, Poland
  7. 7Department of Oncology, District Specialist Hospital, Leśna, Poland
  8. 8Department of Oncological Surgery, Regional Oncology Center, Kraków, Poland
  9. 9Holycross Cancer Center, Kielce, Poland
  10. 10Regional Oncology Hospital, Bielsko Biała, Poland
  11. 11Department of Clinical Genetics, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
  12. 12Department of Surgery and Oncology, University of Zielona Góra, Zielona Góra, Poland
  13. 13Department of Oncology and Immuno-oncology, School of Medicine, Collegium Medicum, Uniwersity of Warmia and Mazury in Olsztyn, Olsztyn, Poland
  14. 144 Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Poland

Abstract

Introduction/Background To estimate the impact of oophorectomy and other treatments onthe survival of breast cancer patients with a CHEK2 mutation.

Methodology Women with Stage I-III breast cancer who were treated at 17hospitals in Poland were tested for four founder mutations in the CHEK2 gene.974 women (10%) were positive for a CHEK2 mutation. Control patientswithout a CHEK2 mutation were selected from a database of patients treatedover the same time period. Information on treatments received and distantrecurrences were retrieved from medical records. Treatments includedchemotherapy, hormonal therapy (tamoxifen) and radiation therapy.Oophorectomies were performed for the treatment of breast cancer or for benignconditions. Dates of death were obtained from the Polish Vital StatisticsRegistry. Causes of death were determined by medical record review. Predictorsof survival were determined using the Cox proportional hazards model.

Results In all, 839 patients with a CHEK2 mutation were matched to 839patients without a mutation. The mean follow-up was 12.0 years. The 15-yearsurvival for CHEK2 carriers was 76.6% and the 15-year survival for non-carriercontrol patients was 78.8% (adjusted HR = 1.06; 95% CI: 0.84–1.34; P = 0.61).Among CHEK2 carriers, the 15-year survival for women who had anoophorectomy was 86.3% and for women who did not have an oophorectomywas 72.1% (adjusted HR = 0.59; 95% CI: 0.38–0.90; P = 0.02). Among controls,the 15-year survival for patients who had an oophorectomy was 84.5% and forwomen who did not have an oophorectomy was 77.6% (adjusted HR = 1.03;95% CI: 0.66–1.61; P = 0.90).

Conclusion Among women with breast cancer and a CHEK2 mutation,oophorectomy is associated with a reduced risk of death from breast cancer.

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