Kathryn A Mills1, Tanvi V Joshi2, Lindsay West3, Michelle Kuznicki4, Laura Kent4, Alexis N Hokenstad5, James C Cripe6, Candice Woolfolk7, Leigha Senter2, Jamie N Bakkum-Gamez5, Robert M Wenham8, David E Cohn2, Victoria Bae-Jump3, Premal H Thaker6. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, United States of America. Electronic address: kmills6@bsd.uchicago.edu. 2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States of America. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of North Carolina, Chapel Hill, NC, United States of America. 4. Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL, United States of America. 5. Division of Gynecologic Oncology, The Mayo Clinic, Rochester, MN, United States of America. 6. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, United States of America. 7. Division of Oncologic Biostatistics, Washington University, St. Louis, MO, United States of America. 8. Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Abstract
OBJECTIVES: This study aimed to assess the association between hormone replacement therapy and the incidence of subsequent malignancies in patients who underwent risk-reducing salpingo-oophorectomy and had mutations predisposing them to Müllerian cancers. METHODS: This Institutional Review Board-approved retrospective study was performed at five academic institutions. Women were included if they were age 18-51 years, had one or more confirmed germline highly penetrant pathogenic variants, and underwent risk-reducing salpingo-oophorectomy. Patients with a prior malignancy were excluded. Clinicodemographic data were collected by chart review. Patients with no documented contact for one year prior to study termination were called to confirm duration of hormone use and occurrence of secondary outcomes. Hormone replacement therapy included any combination of estrogen or progesterone. RESULTS: Data were analyzed for 159 women, of which 82 received hormone replacement therapy and 77 did not. In both groups an average of 6 years since risk reduction had passed. The patients treated with hormone replacement therapy did not have a higher risk of subsequent malignancy than those not treated with hormone replacement therapy (6 out of 82 vs. 7 out of 77, P = .68). Patients who received hormone replacement therapy were younger than those who did not receive hormone replacement therapy (39.0 vs. 43.9 years, P < .01) and were more likely to have undergone other risk reductive procedures including mastectomy and/or hysterectomy, though this difference was not statistically significant (69.5% vs. 55.8%, P = .07). CONCLUSIONS: In this multi-institution retrospective study of data from patients with high-risk variant carriers who underwent risk-reducing salpingo-oophorectomy, there was no statistically significant difference in the incidence of malignancy between women who did and did not receive hormone replacement therapy.
OBJECTIVES: This study aimed to assess the association between hormone replacement therapy and the incidence of subsequent malignancies in patients who underwent risk-reducing salpingo-oophorectomy and had mutations predisposing them to Müllerian cancers. METHODS: This Institutional Review Board-approved retrospective study was performed at five academic institutions. Women were included if they were age 18-51 years, had one or more confirmed germline highly penetrant pathogenic variants, and underwent risk-reducing salpingo-oophorectomy. Patients with a prior malignancy were excluded. Clinicodemographic data were collected by chart review. Patients with no documented contact for one year prior to study termination were called to confirm duration of hormone use and occurrence of secondary outcomes. Hormone replacement therapy included any combination of estrogen or progesterone. RESULTS: Data were analyzed for 159 women, of which 82 received hormone replacement therapy and 77 did not. In both groups an average of 6 years since risk reduction had passed. The patients treated with hormone replacement therapy did not have a higher risk of subsequent malignancy than those not treated with hormone replacement therapy (6 out of 82 vs. 7 out of 77, P = .68). Patients who received hormone replacement therapy were younger than those who did not receive hormone replacement therapy (39.0 vs. 43.9 years, P < .01) and were more likely to have undergone other risk reductive procedures including mastectomy and/or hysterectomy, though this difference was not statistically significant (69.5% vs. 55.8%, P = .07). CONCLUSIONS: In this multi-institution retrospective study of data from patients with high-risk variant carriers who underwent risk-reducing salpingo-oophorectomy, there was no statistically significant difference in the incidence of malignancy between women who did and did not receive hormone replacement therapy.
Authors: Denise R Nebgen; Jean Hurteau; Laura L Holman; Andrea Bradford; Mark F Munsell; Beth R Soletsky; Charlotte C Sun; Gary B Chisholm; Karen H Lu Journal: Gynecol Oncol Date: 2018-05-04 Impact factor: 5.482
Authors: Mary B Daly; Robert Pilarski; Michael Berry; Saundra S Buys; Meagan Farmer; Susan Friedman; Judy E Garber; Noah D Kauff; Seema Khan; Catherine Klein; Wendy Kohlmann; Allison Kurian; Jennifer K Litton; Lisa Madlensky; Sofia D Merajver; Kenneth Offit; Tuya Pal; Gwen Reiser; Kristen Mahoney Shannon; Elizabeth Swisher; Shaveta Vinayak; Nicoleta C Voian; Jeffrey N Weitzel; Myra J Wick; Georgia L Wiesner; Mary Dwyer; Susan Darlow Journal: J Natl Compr Canc Netw Date: 2017-01 Impact factor: 11.908
Authors: C Marchetti; F De Felice; S Boccia; C Sassu; V Di Donato; G Perniola; I Palaia; M Monti; L Muzii; V Tombolini; P Benedetti Panici Journal: Crit Rev Oncol Hematol Date: 2018-10-03 Impact factor: 6.312
Authors: Jonathan S Berek; Eva Chalas; Mitchell Edelson; David H Moore; William M Burke; William A Cliby; Andrew Berchuck Journal: Obstet Gynecol Date: 2010-09 Impact factor: 7.661
Authors: Janice S Kwon; Anna Tinker; Gary Pansegrau; Jessica McAlpine; Melissa Housty; Mary McCullum; C Blake Gilks Journal: Obstet Gynecol Date: 2013-01 Impact factor: 7.661
Authors: D A Levine; O Lin; R R Barakat; M E Robson; D McDermott; L Cohen; J Satagopan; K Offit; J Boyd Journal: Gynecol Oncol Date: 2001-03 Impact factor: 5.482
Authors: Mark H Greene; Marion Piedmonte; Dave Alberts; Mitchell Gail; Martee Hensley; Zoe Miner; Phuong L Mai; Jennifer Loud; Gustavo Rodriguez; Jack Basil; John Boggess; Peter E Schwartz; Joseph L Kelley; Katie E Wakeley; Lori Minasian; Stephen Skates Journal: Cancer Epidemiol Biomarkers Prev Date: 2008-03 Impact factor: 4.254
Authors: Jacques E Rossouw; Garnet L Anderson; Ross L Prentice; Andrea Z LaCroix; Charles Kooperberg; Marcia L Stefanick; Rebecca D Jackson; Shirley A A Beresford; Barbara V Howard; Karen C Johnson; Jane Morley Kotchen; Judith Ockene Journal: JAMA Date: 2002-07-17 Impact factor: 56.272