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Mavaddat N, Antoniou AC, Mooij TM, Hooning MJ, Heemskerk-Gerritsen BA, Noguès C, Gauthier-Villars M, Caron O, Gesta P, Pujol P, Lortholary A, Barrowdale D, Frost D, Evans DG, Izatt L, Adlard J, Eeles R, Brewer C, Tischkowitz M, Henderson A, Cook J, Eccles D, van Engelen K, Mourits MJE, Ausems MGEM, Koppert LB, Hopper JL, John EM, Chung WK, Andrulis IL, Daly MB, Buys SS, Benitez J, Caldes T, Jakubowska A, Simard J, Singer CF, Tan Y, Olah E, Navratilova M, Foretova L, Gerdes AM, Roos-Blom MJ, Van Leeuwen FE, Arver B, Olsson H, Schmutzler RK, Engel C, Kast K, Phillips KA, Terry MB, Milne RL, Goldgar DE, Rookus MA, Andrieu N, Easton DF. Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk: an international prospective cohort of BRCA1 and BRCA2 mutation carriers. Breast Cancer Res 2020; 22:8. [PMID: 31948486 PMCID: PMC6966793 DOI: 10.1186/s13058-020-1247-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/05/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The effect of risk-reducing salpingo-oophorectomy (RRSO) on breast cancer risk for BRCA1 and BRCA2 mutation carriers is uncertain. Retrospective analyses have suggested a protective effect but may be substantially biased. Prospective studies have had limited power, particularly for BRCA2 mutation carriers. Further, previous studies have not considered the effect of RRSO in the context of natural menopause. METHODS A multi-centre prospective cohort of 2272 BRCA1 and 1605 BRCA2 mutation carriers was followed for a mean of 5.4 and 4.9 years, respectively; 426 women developed incident breast cancer. RRSO was modelled as a time-dependent covariate in Cox regression, and its effect assessed in premenopausal and postmenopausal women. RESULTS There was no association between RRSO and breast cancer for BRCA1 (HR = 1.23; 95% CI 0.94-1.61) or BRCA2 (HR = 0.88; 95% CI 0.62-1.24) mutation carriers. For BRCA2 mutation carriers, HRs were 0.68 (95% CI 0.40-1.15) and 1.07 (95% CI 0.69-1.64) for RRSO carried out before or after age 45 years, respectively. The HR for BRCA2 mutation carriers decreased with increasing time since RRSO (HR = 0.51; 95% CI 0.26-0.99 for 5 years or longer after RRSO). Estimates for premenopausal women were similar. CONCLUSION We found no evidence that RRSO reduces breast cancer risk for BRCA1 mutation carriers. A potentially beneficial effect for BRCA2 mutation carriers was observed, particularly after 5 years following RRSO. These results may inform counselling and management of carriers with respect to RRSO.
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Affiliation(s)
- Nasim Mavaddat
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - Thea M. Mooij
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Maartje J. Hooning
- Department of Medical Oncology, Family Center Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Catherine Noguès
- DASC, Oncogénétique Clinique, Institut Paoli-Calmettes, Marseille, France
| | | | - Olivier Caron
- Département de Médecine Oncologique, Gustave Roussy Hôpital Universitaire, Villejuif, France
| | - Paul Gesta
- Centre Hospitalier, Service Régional d’Oncologie Génétique Poitou-Charentes, Niort, France
| | - Pascal Pujol
- Unité d’Oncogénétique, CHU Arnaud de Villeneuve, Montpellier, France
| | - Alain Lortholary
- Centre Catherine de Sienne, Service d’Oncologie Médicale, Nantes, France
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - D. Gareth Evans
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, Manchester University, Central Manchester, University Hospitals NHS Foundation Trust, Manchester, UK
| | - Louise Izatt
- Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital and University of Leeds, Leeds, UK
| | - Ros Eeles
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK
| | - Marc Tischkowitz
- Academic Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Alex Henderson
- Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK
| | - Diana Eccles
- University of Southampton Faculty of Medicine, Southampton University Hospitals NHS Trust, Southampton, UK
| | - Klaartje van Engelen
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marian J. E. Mourits
- Department of Gynaecological Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Linetta B. Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Esther M. John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - Wendy K. Chung
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
| | - Irene L. Andrulis
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario Canada
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
| | - Saundra S. Buys
- Department of Medicine, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
| | - kConFab Investigators
- Research Department, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Javier Benitez
- Human Genetics Group and Genotyping Unit, CEGEN, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Trinidad Caldes
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC (ISCIII), Madrid, Spain
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec, Université Laval Research Center, 2705 Laurier Boulevard, Quebec City, Quebec Canada
| | - Christian F. Singer
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria
| | - Yen Tan
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653 Brno, Czech Republic
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653 Brno, Czech Republic
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marie-José Roos-Blom
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Flora E. Van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Brita Arver
- The Department of Oncology and Pathology, Karolinska Institute, 171 76 Stockholm, Sweden
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Håkan Olsson
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Rita K. Schmutzler
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Karin Kast
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kelly-Anne Phillips
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Medical Oncology Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, East Melbourne, Victoria 8006 Australia
| | - Mary Beth Terry
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Department of Epidemiology, Columbia University, New York, NY USA
| | - Roger L. Milne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
| | - David E. Goldgar
- Department of Dermatology, University of Utah School of Medicine, 30 North 1900 East, SOM 4B454, Salt Lake City, UT 841232 USA
| | - Matti A. Rookus
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Nadine Andrieu
- INSERM, U900, Paris, France
- Institut Curie, Paris, France
- Mines Paris Tech, Fontainebleau, France
- PSL Research University, Paris, France
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - on behalf of IBCCS
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Family Center Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- DASC, Oncogénétique Clinique, Institut Paoli-Calmettes, Marseille, France
- Institut Curie, Service de Génétique, Paris, France
- Département de Médecine Oncologique, Gustave Roussy Hôpital Universitaire, Villejuif, France
- Centre Hospitalier, Service Régional d’Oncologie Génétique Poitou-Charentes, Niort, France
- Unité d’Oncogénétique, CHU Arnaud de Villeneuve, Montpellier, France
- Centre Catherine de Sienne, Service d’Oncologie Médicale, Nantes, France
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, Manchester University, Central Manchester, University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital and University of Leeds, Leeds, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK
- Academic Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
- Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK
- University of Southampton Faculty of Medicine, Southampton University Hospitals NHS Trust, Southampton, UK
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating Center: Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Gynaecological Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario Canada
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
- Department of Medicine, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
- Research Department, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Human Genetics Group and Genotyping Unit, CEGEN, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC (ISCIII), Madrid, Spain
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Genomics Center, Centre Hospitalier Universitaire de Québec, Université Laval Research Center, 2705 Laurier Boulevard, Quebec City, Quebec Canada
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653 Brno, Czech Republic
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Department of Oncology and Pathology, Karolinska Institute, 171 76 Stockholm, Sweden
- Department of Oncology, Lund University Hospital, Lund, Sweden
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medical Oncology Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, East Melbourne, Victoria 8006 Australia
- Department of Epidemiology, Columbia University, New York, NY USA
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
- Department of Dermatology, University of Utah School of Medicine, 30 North 1900 East, SOM 4B454, Salt Lake City, UT 841232 USA
- INSERM, U900, Paris, France
- Institut Curie, Paris, France
- Mines Paris Tech, Fontainebleau, France
- PSL Research University, Paris, France
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - kConFab
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Family Center Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- DASC, Oncogénétique Clinique, Institut Paoli-Calmettes, Marseille, France
- Institut Curie, Service de Génétique, Paris, France
- Département de Médecine Oncologique, Gustave Roussy Hôpital Universitaire, Villejuif, France
- Centre Hospitalier, Service Régional d’Oncologie Génétique Poitou-Charentes, Niort, France
- Unité d’Oncogénétique, CHU Arnaud de Villeneuve, Montpellier, France
- Centre Catherine de Sienne, Service d’Oncologie Médicale, Nantes, France
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, Manchester University, Central Manchester, University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital and University of Leeds, Leeds, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK
- Academic Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
- Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK
- University of Southampton Faculty of Medicine, Southampton University Hospitals NHS Trust, Southampton, UK
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating Center: Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Gynaecological Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario Canada
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
- Department of Medicine, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
- Research Department, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Human Genetics Group and Genotyping Unit, CEGEN, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC (ISCIII), Madrid, Spain
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Genomics Center, Centre Hospitalier Universitaire de Québec, Université Laval Research Center, 2705 Laurier Boulevard, Quebec City, Quebec Canada
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653 Brno, Czech Republic
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Department of Oncology and Pathology, Karolinska Institute, 171 76 Stockholm, Sweden
- Department of Oncology, Lund University Hospital, Lund, Sweden
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medical Oncology Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, East Melbourne, Victoria 8006 Australia
- Department of Epidemiology, Columbia University, New York, NY USA
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
- Department of Dermatology, University of Utah School of Medicine, 30 North 1900 East, SOM 4B454, Salt Lake City, UT 841232 USA
- INSERM, U900, Paris, France
- Institut Curie, Paris, France
- Mines Paris Tech, Fontainebleau, France
- PSL Research University, Paris, France
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
| | - BCFR
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
- Department of Epidemiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Family Center Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- DASC, Oncogénétique Clinique, Institut Paoli-Calmettes, Marseille, France
- Institut Curie, Service de Génétique, Paris, France
- Département de Médecine Oncologique, Gustave Roussy Hôpital Universitaire, Villejuif, France
- Centre Hospitalier, Service Régional d’Oncologie Génétique Poitou-Charentes, Niort, France
- Unité d’Oncogénétique, CHU Arnaud de Villeneuve, Montpellier, France
- Centre Catherine de Sienne, Service d’Oncologie Médicale, Nantes, France
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, Manchester University, Central Manchester, University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital and University of Leeds, Leeds, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK
- Academic Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
- Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK
- University of Southampton Faculty of Medicine, Southampton University Hospitals NHS Trust, Southampton, UK
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating Center: Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Gynaecological Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario Canada
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
- Department of Medicine, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
- Research Department, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Human Genetics Group and Genotyping Unit, CEGEN, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC (ISCIII), Madrid, Spain
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
- Genomics Center, Centre Hospitalier Universitaire de Québec, Université Laval Research Center, 2705 Laurier Boulevard, Quebec City, Quebec Canada
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653 Brno, Czech Republic
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Department of Oncology and Pathology, Karolinska Institute, 171 76 Stockholm, Sweden
- Department of Oncology, Lund University Hospital, Lund, Sweden
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medical Oncology Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, East Melbourne, Victoria 8006 Australia
- Department of Epidemiology, Columbia University, New York, NY USA
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
- Department of Dermatology, University of Utah School of Medicine, 30 North 1900 East, SOM 4B454, Salt Lake City, UT 841232 USA
- INSERM, U900, Paris, France
- Institut Curie, Paris, France
- Mines Paris Tech, Fontainebleau, France
- PSL Research University, Paris, France
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Strangeways Research Laboratory, Worts Causeway, University of Cambridge, Cambridge, CBI 8RN UK
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