TY - JOUR
T1 - Breast Density Changes after Risk-Reducing Salpingo-oophorectomy in Women with a Pathogenic Germline Variant in BRCA1 or BRCA2
AU - IBCCS
AU - Loehrer, Elizabeth A.
AU - van der Baan, Frederieke H.
AU - Mooij, Thea M.
AU - Andrieu, Nadine
AU - Antoniou, Antonis C.
AU - Dorrius, Monique D.
AU - Easton, Douglas F.
AU - Engel, Christoph
AU - Kast, Karin
AU - Mann, Ritse M.
AU - Noguès, Catherine
AU - Schmutzler, Rita K.
AU - Tan, Yen Y.
AU - Eriksson, Mikael
AU - van Gils, Carla H.
AU - Hooning, Maartje J.
AU - Rookus, Matti A.
AU - Schmidt, Marjanka K.
N1 - Publisher Copyright:
©2025 The Authors.
PY - 2025/8/1
Y1 - 2025/8/1
N2 - Background: We studied changes in mammographic density (MD) among premenopausal women with a pathogenic germline variant (PGV) in the BRCA1 or BRCA2 gene, comparing those who did and did not undergo risk-reducing salpingo-oophorectomy (RRSO) in the interval between mammograms, accounting for changes in exogenous oral contraceptive or hormone replacement therapy (HRT) use. Methods: From five studies of the International BRCA1/2 Carrier Cohort Study consortium, we included 691 participants who had two or more screening mammograms available, were less than 47 years at the time of RRSO (N = 208), or premenopausal at all mammograms without RRSO (N = 483). MD metrics [percent density (PD), dense area (DA), and non-DA] were quantified using STRATUS. Multivariable linear mixed models assessed changes in MD metrics between groups, adjusting for confounders. Results: The mean PD at first mammogram was 26.8% ± 15.3 (RRSO) and 31.3% ± 18.1 (no RRSO). In a median 1.1 years between mammograms, PD decreased on average by 0.9% [95% confidence interval (CI), -1.6 to -0.2] among women who did not undergo RRSO in the interval between mammograms compared with 5.9% (95% CI, -7.4 to -4.5) among women who underwent RRSO in the interval (adjusted difference, -5.9%; 95% CI, -9.5 to -2.2; P = 0.002). Results were driven primarily by MD changes among BRCA2 PGV carriers. The use of HRT after RRSO attenuated the decline in PD. Conclusions: On average, PD and DA decrease following RRSO in premenopausal carriers, particularly among BRCA2 PGV carriers. HRT formulation affects MD changes.Impact: A decrease in MD may inform the potential protective effect of RRSO against breast cancer.
AB - Background: We studied changes in mammographic density (MD) among premenopausal women with a pathogenic germline variant (PGV) in the BRCA1 or BRCA2 gene, comparing those who did and did not undergo risk-reducing salpingo-oophorectomy (RRSO) in the interval between mammograms, accounting for changes in exogenous oral contraceptive or hormone replacement therapy (HRT) use. Methods: From five studies of the International BRCA1/2 Carrier Cohort Study consortium, we included 691 participants who had two or more screening mammograms available, were less than 47 years at the time of RRSO (N = 208), or premenopausal at all mammograms without RRSO (N = 483). MD metrics [percent density (PD), dense area (DA), and non-DA] were quantified using STRATUS. Multivariable linear mixed models assessed changes in MD metrics between groups, adjusting for confounders. Results: The mean PD at first mammogram was 26.8% ± 15.3 (RRSO) and 31.3% ± 18.1 (no RRSO). In a median 1.1 years between mammograms, PD decreased on average by 0.9% [95% confidence interval (CI), -1.6 to -0.2] among women who did not undergo RRSO in the interval between mammograms compared with 5.9% (95% CI, -7.4 to -4.5) among women who underwent RRSO in the interval (adjusted difference, -5.9%; 95% CI, -9.5 to -2.2; P = 0.002). Results were driven primarily by MD changes among BRCA2 PGV carriers. The use of HRT after RRSO attenuated the decline in PD. Conclusions: On average, PD and DA decrease following RRSO in premenopausal carriers, particularly among BRCA2 PGV carriers. HRT formulation affects MD changes.Impact: A decrease in MD may inform the potential protective effect of RRSO against breast cancer.
UR - https://www.scopus.com/pages/publications/105012862783
U2 - 10.1158/1055-9965.EPI-25-0218
DO - 10.1158/1055-9965.EPI-25-0218
M3 - Article
C2 - 40465393
AN - SCOPUS:105012862783
SN - 1055-9965
VL - 34
SP - 1295
EP - 1305
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 8
ER -