A 38-year-old BRCA1 carrier undergoes risk-reducing bilateral salpingo-oophorectomy. Which statement regarding her subsequent breast cancer risk is most accurate?
- A Risk is reduced by approximately 50% if performed before age 40 ✓
- B Risk is eliminated because BRCA1 breast cancer is oestrogen-independent
- C Risk is unchanged; only ovarian cancer risk is reduced
- D Risk reduction is greater for BRCA2 than BRCA1 carriers
Correct answer: A. Risk is reduced by approximately 50% if performed before age 40
Explanation
Risk-reducing bilateral salpingo-oophorectomy in BRCA1 carriers before age 40 reduces breast cancer risk by approximately 50% by eliminating ovarian oestrogen production, even though BRCA1-associated tumours are often hormone receptor-negative. BRCA2-associated breast cancers are more hormone receptor-positive, making oophorectomy somewhat more effective for BRCA2 carriers, but option A remains the closest correct statement for BRCA1.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.