Table 4.

Sensitivity analysis on gains in life expectancy for BRCA1 and BRCA2 mutation carriers as duration of protective effect from prophylactic oophorectomy is varied

Life expectancy, y
Age at BRCA carrier status determination and number of years of post-oophorectomy protective effect
Strategy30, Lifetime PO protective effect30, 10 year PO protective effect30, 15 year PO protective effect40, Lifetime PO protective effect40, 10 year PO protective effect40, 15 year PO protective effect
BRCA1 mutation carrier
No S and no PM and no PO41.541.641.532.732.932.9
Gain in life expectancy, y
 PO7.44.44.96.14.85.2
 PM and PO10.310.010.19.18.98.9
 S and PO8.87.27.57.66.87.0
Gain in life expectancy when prophylactic surgery is delayed by 5 y
 Delayed PO7.04.65.35.04.24.5
 Delayed PM and PO9.69.39.47.06.86.9
 S and delayed PO8.67.27.66.76.26.4
 S and delayed PM and PO9.99.69.77.87.67.7
Gain in life Expectancy when prophylactic surgery is delayed by 10 y
 Delayed PO5.54.54.82.82.82.8
 Delayed PM and PO8.28.08.15.04.84.9
 S and delayed PO7.67.07.25.35.35.3
 S and delayed PM and PO9.08.88.96.56.36.4
Life expectancy, y
Age at BRCA carrier status determination and number of years of post-oophorectomy protective effect
Strategy30, Lifetime PO protective effect30, 10-year PO protective effect30, 15-year PO protective effect40, Lifetime PO protective effect40, 10-year PO protective effect40, 15-year PO protective effect
BRCA2 mutation carrier
No S and no PM and no PO48.648.848.839.439.639.5
Gain in life expectancy, y
 PO3.01.31.52.41.41.6
 PM and PO4.44.14.23.93.73.7
 S and PO3.72.72.83.12.52.7
Gain in life expectancy when prophylactic surgery is delayed by 5 y
 Delayed PO2.91.41.62.21.51.7
 Delayed PM and PO4.13.83.93.43.23.3
 S and delayed PO3.62.72.93.02.52.7
 S and delayed PM & PO4.24.04.03.63.43.5
Gain in life expectancy when prophylactic surgery is delayed by 10 y
 Delayed PO2.31.31.61.21.21.2
 Delayed PM and PO3.73.53.53.02.82.9
 S and delayed PO3.32.72.92.72.62.6
 S and delayed PM and PO4.03.83.93.63.43.4

NOTE: All gains are reported in addition to the base life expectancy, in which no intervention is conducted. Assumptions underlying results are ages at genetic testing for BRCA1/2 mutations are 30 and 40 years; the duration of PO's impact on breast cancer risk reduction is: lifetime, 10 years and 15 years, respectively.

Abbreviations: PM, prophylactic mastectomy; PO, prophylactic oophorectomy; S, screening.