Ovarian removal and subsequent breast cancer prognosis: a nationwide cohort study
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Purpose: To evaluate whether previous ovarian removal concomitant with benign hysterectomy improves prognosis in a cohort of women with breast cancer. Methods: In this nationwide register-based cohort study, risk of recurrence and mortality were examined in 4563 women with invasive breast cancer and previous bilateral salpingo-oophorectomy (BSO) concomitant with benign hysterectomy, during 1977–2018. Comparing with benign hysterectomy alone, hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated by Cox-proportional hazards regression models. Analyses were stratified on age at hysterectomy as a proxy for menopausal status (< 45, 45–54 and ≥ 55 years); tumor characteristics, estrogen receptor (ER)-status, and use of hormone therapy (HT) were included in multivariable models. Results: Compared with hysterectomy alone, premenopausal (< 45 years) BSO at benign hysterectomy was associated with an age and calendar period adjusted HR of 1.48 (95% CI 0.83–2.65) for breast cancer recurrence within 10 years of follow-up, a HR of 1.07 (95% CI 0.66–1.72) for overall mortality after breast cancer, and a HR of 0.59 (95% CI 0.26–1.32) for breast cancer-specific mortality. The corresponding HRs for postmenopausal (≥ 55 years) BSO at benign hysterectomy were 1.51 (95% CI 0.73–3.12) for recurrences, 1.34 (95% CI 0.74–2.44) for overall mortality, and 1.78 (95% CI 0.74–4.30) for breast cancer mortality. Adjusting for tumor characteristics, ER-status and HT did not alter the results. Conclusion: Results from this cohort study did not indicate an improvement in breast cancer prognosis when removing the ovaries at benign hysterectomy prior to the cancer diagnosis.
Original language | English |
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Journal | Breast Cancer Research and Treatment |
Volume | 197 |
Issue number | 3 |
Pages (from-to) | 583-591 |
Number of pages | 9 |
ISSN | 0167-6806 |
DOIs | |
Publication status | Published - 2023 |
Bibliographical note
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
- Bilateral salpingo-oophorectomy, Breast cancer prognosis, Cancer epidemiology, Cohort study
Research areas
ID: 340553795