Citations 1
Risk of Breast Cancer After Ovarian Cancer in Women With a Pathogenic/Likely Pathogenic Variant in BRCA1 or BRCA2
Apostol, Adriana Ionelia , Gronwald, J., Cybulski, C., Kim, Raymond H. , Møller, P., Karlan, B., Bordeleau, Louise , Schrader, Intan , Cajal, Teresa Ramón y , Pal, Tuya, Eisen, Andrea, Singer, Christian F., Couch, Fergus J., Zakalik, Dana , Metcalfe, Kelly , Olopade, Olufunmilayo, Tung, Nadine, Fruscio, R, Foulkes, William D., Sun, P., Lubinski, J., Narod, Steven A., Sweet, Kevin , Elser, Christine , Panchal, Seema, Wiesner, Georgia L. , Armel, Susan, Steele, Linda, Serfas, Kim, Cullinane, Carey A., Reilly, Robert E., Mercer, L J, Dungan, Jeffrey R., Cohen, Stephanie, Neuhausen, Susan, Sun, Sophie, Blum, Joanne L., Stempa, Klaudia , Graham, Tracy Ann, Seca, Marta , Marchette, Martina Delle , Dell'Oro, Cristina, Alfonso, Rosa Moreno, Lopez, Consol, Cusco, Francesco, Karlan, Beth Y. , Schrader, Kasmintan A. , Eisen, Andrea , Apostol, Adriana I , Cybulski, Cezary , Karlan, Beth Y , Ramón Y Cajal, Teresa , Singer, Christian F , Couch, Fergus J. , Olopade, Olufunmilayo I , Tung, Nadine , Fruscio, Robert , Foulkes, William D , Aeilts, Amber M , Lubinski, Jan , Narod, Steven A , Kotsopoulos, Joanne , Metcalfe, Kelly A , Eisen, Andrea , Bordeleau, Louise , Kim, Raymond H , Cybulski, Cezary , Møller, Pål , Pal, Tuya , Singer, Christian F. , Couch, Fergus J. , Olopade, Olufunmilayo I. , Tung, Nadine , Foulkes, William D. , Aeilts, Amber M. , Lubiński, Jan , Narod, Steven A. , Kotsopoulos, Joanne , Steele, Linda, Saal, Howard M. , Rayson, Daniel , Mercer, Leanne, Cohen, Stephanie, Neuhausen, Susan L, Senter, Leigha , Blum, Joanne Lorraine , Negri, Serena , Dell’Oro, Cristina, Inzoli, Alessandra , Alfonso, Rosa
Journal of Clinical Oncology | February 28, 2026 | Volume: 44 | Issue: 10 | Pages: 883-892
PURPOSE BRCA carriers face high risks of developing both breast and ovarian/fallopian tube cancers (hereafter referred to as ovarian ). Among BRCA carriers with ovarian cancer, it is not clear whether the risk of breast cancer is sufficiently high that risk-reducing mastectomy should be offered. This study aimed to assess the risk of breast cancer BRCA carriers after a diagnosis of ovarian cancer. METHODS We included women with a pathogenic/likely pathogenic variant in BRCA1 or BRCA2 , a diagnosis of ovarian cancer, and no other cancer history and no risk-reducing bilateral mastectomy. Women were followed for incident breast cancer from the date of ovarian cancer diagnosis or the date of baseline questionnaire, whichever came last. The 5-, 10-, and 15-year cumulative risks of breast cancer were compared for women with ovarian cancer and an age-matched set of control women without ovarian cancer. RESULTS A total of 960 participants with ovarian cancer were identified (814 BRCA1 and 146 BRCA2 carriers). After a mean follow-up of 4.9 years, 41 women (4.3%) developed breast cancer, at a mean age at diagnosis of 57.5 years (range, 39-74). Actuarial cumulative breast cancer risks after ovarian cancer were 4.4%, 8.9%, and 11.5% at 5, 10, and 15 years, respectively. Only three breast cancer–related deaths occurred. Among 741 age-matched BRCA carriers without ovarian cancer, actuarial cumulative risks of breast cancer were 20.9%, 38.6%, and 47.2% at 5, 10, and 15 years, respectively. The hazard ratio for breast cancer, after an ovarian cancer diagnosis, compared with no ovarian cancer, was 0.18 ([95% CI, 0.12 to 0.27]; P < .0001). CONCLUSION After ovarian cancer, BRCA carriers have a relatively low risk of breast cancer. Risk-reducing mastectomy should not be recommended routinely, but might be considered for long-term survivors. Magnetic resonance imaging surveillance and/or mammography is a realistic alternative.