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dc.contributor.authorObermair, Andreas
dc.contributor.authorYoulden, Danny R
dc.contributor.authorBaade, Peter D
dc.contributor.authorJanda, Monika
dc.date.accessioned2017-05-03T15:23:48Z
dc.date.available2017-05-03T15:23:48Z
dc.date.issued2014
dc.identifier.issn0020-7136
dc.identifier.doi10.1002/ijc.28537
dc.identifier.urihttp://hdl.handle.net/10072/66511
dc.description.abstractProphylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in breast cancer susceptibility gene (BRCA)-positive women, whereas in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n = 21,067). We fitted flexible parametric breast cancer-specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of risk-reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20-49 and 50-79 years, respectively. Overall, 1,426 women (7%) underwent risk-reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk-reducing surgery compared to 171 who did not have risk-reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall [adjusted hazard ration (HR), 0.69; 95% confidence interval (CI), 0.53-0.89; p = 0.005]. Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45; 95% CI, 0.25-0.79; p < 0.006). This was largely driven by reduction in breast cancer-specific mortality (HR, 0.43; 95% CI, 0.24-0.79; p < 0.006). This population-based study found that risk-reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts and subsequently randomised trials are needed to confirm these findings.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent87560 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoeng
dc.publisherJohn Wiley & Sons
dc.publisher.placeUnited States
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom2211
dc.relation.ispartofpageto2222
dc.relation.ispartofjournalInternational journal of cancer. Journal international du cancer
dc.relation.ispartofvolume134
dc.rights.retentionY
dc.subject.fieldofresearchOncology and carcinogenesis
dc.subject.fieldofresearchOncology and carcinogenesis not elsewhere classified
dc.subject.fieldofresearchcode3211
dc.subject.fieldofresearchcode321199
dc.titleThe impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer-A population-based data linkage study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2014 UICC. This is the pre-peer reviewed version of the following article: The impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer—A population-based data linkage study, International Journal of Cancer, Volume 134, Issue 9, pages 2211–2222, 01 May 2014, which has been published in final form at http://dx.doi.org/10.1002/ijc.28537
gro.hasfulltextFull Text
gro.griffith.authorBaade, Peter D.
gro.griffith.authorYoulden, Danny R.


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