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Clinical Studies

The impact of oophorectomy on survival from breast cancer in patients with CHEK2 mutations

British Journal of Cancer volume 127, pages 84–91 (2022)Cite this article

Subjects

Abstract

Background

To estimate the impact of oophorectomy and other treatments on the survival of breast cancer patients with a CHEK2 mutation.

Methods

Women with Stage I–III breast cancer who were treated at 17 hospitals in Poland were tested for four founder mutations in the CHEK2 gene. 974 women (10%) were positive for a CHEK2 mutation. Control patients without a CHEK2 mutation were selected from a database of patients treated over the same time period. Information on treatments received and distant recurrences were retrieved from medical records. Treatments included chemotherapy, hormonal therapy (tamoxifen) and radiation therapy. Oophorectomies were performed for the treatment of breast cancer or for benign conditions. Dates of death were obtained from the Polish Vital Statistics Registry. Causes of death were determined by medical record review. Predictors of survival were determined using the Cox proportional hazards model.

Results

In all, 839 patients with a CHEK2 mutation were matched to 839 patients without a mutation. The mean follow-up was 12.0 years. The 15-year survival for CHEK2 carriers was 76.6% and the 15-year survival for non-carrier control patients was 78.8% (adjusted HR = 1.06; 95% CI: 0.84–1.34; P = 0.61). Among CHEK2 carriers, the 15-year survival for women who had an oophorectomy was 86.3% and for women who did not have an oophorectomy was 72.1% (adjusted HR = 0.59; 95% CI: 0.38–0.90; P = 0.02). Among controls, the 15-year survival for patients who had an oophorectomy was 84.5% and for women who did not have an oophorectomy was 77.6% (adjusted HR = 1.03; 95% CI: 0.66–1.61; P = 0.90).

Conclusion

Among women with breast cancer and a CHEK2 mutation, oophorectomy is associated with a reduced risk of death from breast cancer.

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Data availability

All data relevant to the study are included in the article.

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Funding

The work described in this article was funded by the Polish Ministry of Health. Steven Narod is a recipient of a Canada Research Chair Tier 1 and is supported by the Peter Gilgan Center for Women’s Cancers at Women’s College Hospital.

Author information

Authors and Affiliations

  1. Department of Histology, Department of Biology and Genetics, Faculty of Medicine, University of Opole, Opole, Poland

    Joanna Tomiczek-Szwiec

  2. Department of Surgery and Oncology, University of Zielona Góra, Zyty 28 St, 65-046, Zielona Góra, Poland

    Marek Szwiec & Robert Sibilski

  3. Department of Clinical Oncology, University Hospital in Zielona Góra, Zyty 26 St, 65-046, Zielona Góra, Poland

    Marek Szwiec

  4. Regional Oncology Hospital, Strzalowska 22, 71-730, Szczecin, Poland

    Michal Falco

  5. Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Unii Lubelskiej 1 St, 71-252, Szczecin, Poland

    Cezary Cybulski, Dominika Wokolorczyk, Anna Jakubowska, Jacek Gronwald, Jan Lubinski & Tomasz Huzarski

  6. Department of Clinical Genetics and Pathology, University of Zielona Góra, Zyty 28 St, 65-046, Zielona Góra, Poland

    Malgorzata Stawicka & Tomasz Huzarski

  7. OPEN, Kazimierza Wielkiego 24 St, 61-863, Poznań, Poland

    Dariusz Godlewski

  8. Department of Oncology, District Specialist Hospital, Leśna 27-29 St, 58-100, Świdnica, Poland

    Ewa Kilar

  9. Department of Oncological Surgery, Regional Oncology Center, Gancarska 11 St, 31-115, Kraków, Poland

    Elzbieta Marczyk

  10. Holycross Cancer Center, Artwińskiego 3 St, 25-734, Kielce, Poland

    Monika Siołek

  11. Regional Oncology Hospital, Wyzwolenia 18 St, 43-300, Bielsko Biała, Poland

    Rafal Wiśniowski

  12. Department of Clinical Genetics, Collegium Medicum, Nicolaus Copernicus University, Jagiellońska 13 St, 85-067, Bydgoszcz, Poland

    Olga Haus

  13. Oncology Diagnostic Center, Wazów 42 St, 65-044, Zielona Góra, Poland

    Robert Sibilski

  14. Department of Oncology and Immuno-oncology, School of Medicine, Collegium Medicum, Uniwersity of Warmia and Mazury in Olsztyn, Warszawska 30 St, 10-082, Olsztyn, Poland

    Lubomir Bodnar

  15. Women’s College Research Institute, Toronto, Ontario, M5S 1B2, Canada

    Ping Sun & Steven A. Narod

  16. Regional Oncology Center, Łódz, Poland

    M. Błasińska-Morawiec, A. Jeziorski & Z. Morawiec

  17. Pomeranian Medical University, Szczecin, Poland

    M. Chosia & O. Oszurek

  18. Regional Oncology Center, Opole, Poland

    K. Drosik

  19. University of Medical Sciences, Poznan, Poland

    S. Gozdecka-Grodecka

  20. Regional Oncology Center, Kielce, Poland

    S. Goźdź & B. Kozak-Klonowska

  21. The Maria Sklodowska-Curie Institute-Oncology Center, Gliwice, Poland

    E. Grzybowska & D. Lange

  22. Greater Poland Cancer Centre, Poznań, Poland

    A. Karczewska, K. Lamperska & A. Mackiewicz

  23. Medical University of Łódz, Łódz, Poland

    R. Kordek

  24. Military Institute of Medicine, Warsaw, Poland

    A. Synowiec & C. Szczylik

  25. Regional Oncology Center, Kraków, Poland

    J. Mituś, J. Ryś & K. Urbański

  26. Hospital Ministry of the Interior and Administration & Warmia and Masuria Oncology Centre, Olsztyn, Poland

    S. Niepsuj

  27. District Specialist Hospital, Olsztyn, Poland

    K. Gugala

  28. Regional Oncology Center, Bydgoszcz, Poland

    T. Mierzwa

  29. Regional Oncology Center, Białystok, Poland

    M. Posmyk

  30. Regional Oncology Hospital, Szczecin, Poland

    M. Uciński

  31. Provincial Specialist Hospital, Rzeszów, Poland

    B. Waśko

  32. Regional Oncology Hospital, Bielsko Biała, Poland

    P. Wandzel

Authors
  1. Joanna Tomiczek-Szwiec
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  2. Marek Szwiec
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  3. Michal Falco
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  4. Cezary Cybulski
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  5. Dominika Wokolorczyk
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  6. Anna Jakubowska
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  7. Jacek Gronwald
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  8. Malgorzata Stawicka
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  9. Dariusz Godlewski
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  10. Ewa Kilar
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  11. Elzbieta Marczyk
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  12. Monika Siołek
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  13. Rafal Wiśniowski
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  14. Olga Haus
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  15. Robert Sibilski
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  16. Lubomir Bodnar
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  17. Ping Sun
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  18. Steven A. Narod
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  19. Jan Lubinski
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  20. Tomasz Huzarski
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Consortia

the Polish Breast Cancer Consortium

  • M. Błasińska-Morawiec
  • , M. Chosia
  • , K. Drosik
  • , S. Gozdecka-Grodecka
  • , S. Goźdź
  • , E. Grzybowska
  • , A. Jeziorski
  • , A. Karczewska
  • , R. Kordek
  • , A. Synowiec
  • , B. Kozak-Klonowska
  • , K. Lamperska
  • , D. Lange
  • , A. Mackiewicz
  • , J. Mituś
  • , S. Niepsuj
  • , O. Oszurek
  • , K. Gugala
  • , Z. Morawiec
  • , T. Mierzwa
  • , M. Posmyk
  • , J. Ryś
  • , C. Szczylik
  • , M. Uciński
  • , K. Urbański
  • , B. Waśko
  •  & P. Wandzel

Contributions

JT-S, MS and MF reviewed clinical information prepared the data files and conducted quality control. CC, DW and AJ conducted the laboratory analyses. JG, MS, DG, EK, EM, MS, RW, OH, RS and LB submitted clinical data and performed the medical review. PS and SAN performed the statistical analysis and edited the paper. JL and TH conceived of the paper and co-ordinated the collaborative group.

Corresponding author

Correspondence to Steven A. Narod.

Ethics declarations

Competing interests

SAN is an editorial board member of BJC. The remaining authors declare no competing interests.

Ethics approval and consent to participate

The study is exempt from informed patient consent and board approval by the Women’s College Hospital Ethics Board. The study was performed in accordance with the Declaration of Helsinki.

Consent to publish

Individual personal data are not included.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Prof. Jan Lubinski is the nominated Consortium representative.

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Tomiczek-Szwiec, J., Szwiec, M., Falco, M. et al. The impact of oophorectomy on survival from breast cancer in patients with CHEK2 mutations. Br J Cancer 127, 84–91 (2022). https://doi.org/10.1038/s41416-022-01770-1

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