Risk of Endometrial Cancer in UK Carriers of BRCA Mutations

Dawn O'Shea

August 07, 2020

Researchers at the University of Manchester say women with a BRCA pathogenic variant do not appear to have a significant increased risk of all-type or serous-like endometrial cancer.

The team calculated standardised incidence ratios (SIRs) for endometrial cancer in four distinct cohorts using a prospectively maintained database of BRCA pathogenic variant carriers at the Manchester Centre for Genomic Medicine to identify individuals aged >20 years.

Women were eligible for the study if they had a BRCA1 or BRCA2 pathogenic variant identified between 1 January 1991 and 31 December 2017 and had not undergone a previous hysterectomy.

Women were considered according to a number of distinct but overlapping cohorts;

  1. Retrospectively assuming the follow-up started on 1 January, 1980 or age 20 years, whichever occurred later.

  2. Prospectively from the date of their family BRCA pathogenic variant identification or age 20 years.

  3. Prospectively from the date of their personal BRCA pathogenic variant identification or age 20 years.

  4. Prospectively from the date of risk-reducing salpingo-oophorectomy (RRSO), where applicable.

Fourteen cases of endometrial cancer were identified in 2609 women (1350 BRCA1 and 1259 BRCA2), of which two were prospectively diagnosed.

The overall risk of endometrial cancer was not significantly increased in any of the four cohorts studied (Cohort 1 adjusted SIR=1.70; 95% CI 0.74-3.33; Cohort 2 adjusted SIR=0.89; 95% CI 0.12-3.02; Cohort 3 adjusted SIR=1.21; 95% CI 0.09-4.48. The date of RRSO adjusted SIR was incalculable). No cases of serous endometrial cancer diagnosed.

The results were unaffected by the BRCA gene affected, previous breast cancer, or tamoxifen use.

No BRCA pathogenic variants were detected in any of the serous endometrial cancers tested.

The authors say the data provide reassurance that hysterectomy is unlikely to be of significant benefit if performed solely as a preventive measure.

Eur J Cancer. Published online July 19, 2020. Full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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