很少有研究调查对携带致病性种系 BRCA1 或 BRCA2 变异的先前切除的乳腺癌患者进行预防性输卵管卵巢切除术 (PSO) 是否与癌症特异性死亡风险降低相关。 ) 象限切除术或乳房切除术作为 BRCA1 或 BRCA2 乳腺癌患者主要治疗后的预后。这项回顾性队列研究是在单一机构的三级转诊中心进行的。研究人员招募了 1972 年至 2019 年间连续接受手术治疗的浸润性乳腺癌患者，并在发现携带 BRCA1 或 BRCA2 基因变异后进行前瞻性随访。数据分析于 2022 年 4 月至 2023 年 7 月期间进行。乳房手术后，一些患者接受了 PSO、PM 或两者都接受，而其他患者则没有。主要研究终点是通过 Kaplan-Meier 方法测量的总生存期。次要终点是乳腺癌特异性死亡率、同侧乳腺肿瘤复发 (IBTR)、对侧乳腺癌、卵巢癌和卵巢癌特异性死亡率的粗累积发生率。队列中包括 480 名患者（初次手术时的中位年龄， 40.0 岁；IQR，34.0-46.0 岁），PSO 与死亡风险显着降低相关（风险比 [HR]，0.40；95% CI，0.25-0.64；P < .001）。对于携带 BRCA1 变异的患者（HR，0.35；95% CI，0.20-0.63；P = .001）和三阴性疾病患者（HR，0.21；95% CI，0.09-0.46；P），这种降低最为明显。 = .002），以及浸润性导管癌患者（HR，0.51；95% CI，0.31-0.84；P = .008）。预防性输卵管卵巢切除术与对侧乳腺癌或 IBTR 的风险无关。初始或延迟的 PM 与 IBTR 风险降低相关，但与总体生存率或乳腺癌特异性死亡率无关。研究结果表明，应向所有接受手术以减少 IBTR 风险的 BRCA1/2 乳腺癌患者提供 PSO。死亡风险。特别是，应在乳房手术时向 BRCA1 变异患者提供 PSO。

Few studies have investigated whether prophylactic salpingo-oophorectomy (PSO) for patients with previously resected breast cancer who carry pathogenic germline BRCA1 or BRCA2 variants is associated with a reduced risk of cancer-specific death.To assess the association of PSO and prophylactic mastectomy (PM) with prognosis after quadrantectomy or mastectomy as primary treatment for patients with BRCA1 or BRCA2 breast cancer.This retrospective cohort study was performed in a single-institution, tertiary referral center. Consecutive patients with invasive breast cancer treated surgically between 1972 and 2019 were recruited and followed up prospectively after they were found to carry the BRCA1 or BRCA2 gene variant. The data analysis was performed between April 2022 and July 2023.Following breast surgery, some patients underwent PSO, PM, or both, whereas others did not.The primary study end point was overall survival as measured by the Kaplan-Meier method. Secondary end points were crude cumulative incidence of breast cancer-specific mortality, ipsilateral breast tumor recurrence (IBTR), contralateral breast cancer, ovarian cancer, and ovarian cancer-specific mortality.Of 480 patients included in the cohort (median age at initial surgery, 40.0 years; IQR, 34.0-46.0 years), PSO was associated with a significantly reduced risk of death (hazard ratio [HR], 0.40; 95% CI, 0.25-0.64; P < .001). This reduction was most evident for patients carrying the BRCA1 variant (HR, 0.35; 95% CI, 0.20-0.63; P = .001), those with triple-negative disease (HR, 0.21; 95% CI, 0.09-0.46; P = .002), and those with invasive ductal carcinoma (HR, 0.51; 95% CI, 0.31-0.84; P = .008). Prophylactic salpingo-oophorectomy was not associated with risk of contralateral breast cancer or IBTR. Initial or delayed PM was associated with a reduced risk of IBTR but not with overall survival or breast cancer-specific mortality.The study findings suggest that PSO should be offered to all patients with BRCA1/2 breast cancer who undergo surgery with curative intent to reduce risk of death. In particular, PSO should be offered to patients with the BRCA1 variant at the time of breast surgery.