The Risk Reduction And Survival Benefit Of Risk-Reducing Salpingo-Oophorectomy In Breast Cancer With BRCA Gene Mutation:A Meta-Analysis

Background and Objective:Breast cancer is one of the most common malignant tumors in women,and BRCA gene,as one of the related susceptibility genes of breast cancer,its mutation can lead to a significant increase in the risk of breast cancer.A large number of previous studies have shown that risk-reducing salpingo-oophorectomy can reduce the risk of BRCA mutated breast cancer and improve its survival,while several large-scale studies in recent years had come to the opposite conclusion.The purpose of this study is to clarify,by meta-analysis,the relationship between risk-reducing salpingo-oophorectomy and breast cancer-related risks and survival of BRCA mutation carriers.Methods:A comprehensive search of PubMed and EMBASE databases from the time they were created to November 2017 was conducted.The hazard ratio（HRs）required for data analysis were obtained directly from the original studies.Statistical heterogeneity among studies was evaluated by Q-test.To assess the possibility of publication bias,we used Begg test.All analyses were performed using software stata/sev12.0.P<0.05 was considered statistically significant.Results:Risk-reducing salpingo-oophorectomy significantly reduced the incidence of breast cancer in BRCA mutated women without breast cancer history（HR=0.58,95%CI=0.37-0.78）.Even for women with a history of breast cancer,salpingo-oophorectomy can also reduce the risk of recurrence（HR=0.50,95%CI=0.31-0.69）.In particular,the publication year of these studies may be considered as the influential factors in the subgroup analysis of breast cancer risk(P_{heterogeneity}=0.024).Finally,we also found that risk-reducing salpingo-oophorectomy can improve the breast cancer survival of BRCA mutated women（HR=0.33,95%CI=0.28-0.38）.Conclusion:In this study,risk-reducing salpingo-oophorectomy was associated with a reduced risk of breast cancer due to BRCA mutations,and the year of publication of the original studies was a key influence factor.In addition,risk-reducing salpingo-oophorectomy could reduce the mortality of breast cancer associated with BRCA gene to vary degrees.