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Ovarian removal at or after benign hysterectomy and breast cancer: a nationwide cohort study

  • Epidemiology
  • Published:
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Abstract

Purpose

Large-scale population-based registry studies investigating the risk of breast cancer after removal of both ovaries at hysterectomy for benign conditions in women with no known genetic predisposition to cancer are needed. We aimed to perform such a study taking into account the age at surgery status and use of hormone replacement therapy (HRT).

Methods

Within the female population of Denmark born 1937–1996, we evaluated breast cancer incidence after unilateral or bilateral oophorectomy concomitant with or after benign hysterectomy in comparison with no surgery and with hysterectomy alone using health registry data during 1978–2016. In a subpopulation followed from 1996, the analyses were stratified according to use of HRT.

Results

We found a reduced risk of breast cancer among women aged < 45 years at bilateral oophorectomy compared with women with hysterectomy alone (HR = 0.78; 95% CI 0.66, 0.92), whereas slightly increased risks were seen in women above 50 years. In the subpopulation, non-users of HRT aged ≥ 50 years at oophorectomy had a HR of 0.74 (95% CI 0.56, 0.98) for breast cancer after bilateral oophorectomy compared with hysterectomy alone.

Conclusions

Our large-scale study covering four decades provides evidence that bilateral oophorectomy performed at young age in women with benign indications for hysterectomy is associated with a reduction in breast cancer risk. The finding of a negative association at older ages in women not using HRT deserves further attention.

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Data availability

The datasets generated and analyzed during the current study are not publicly available, since the authors do not have permission to share the data.

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Acknowledgements

The authors would like to thank Lea Elsborg Olsen and Rasmus Hertzum-Larsen for help with data management.

Funding

This work was supported by the Danish Cancer Society's Scientific Committee (KBVU) (Grant No. R167-A11019-17-S2).

Author information

Authors and Affiliations

  1. Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Mathilde Gottschau, Susanne K. Kjær, Annet Bens, Allan Jensen, Christian Munk & Lene Mellemkjær

  2. Department of Gynecology, Rigshospitalet University Hospital, University of Copenhagen, Blegdamsvej 3, 2100, Copenhagen, Denmark

    Susanne K. Kjær

  3. Department of Obstetrics and Gynecology, North Zealand Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hillerød, Denmark

    Annette Settnes

  4. Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Gitte Lerche Aalborg

Authors
  1. Mathilde Gottschau
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  2. Susanne K. Kjær
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  3. Annette Settnes
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  4. Gitte Lerche Aalborg
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  5. Annet Bens
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  6. Allan Jensen
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  7. Christian Munk
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  8. Lene Mellemkjær
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Corresponding author

Correspondence to Lene Mellemkjær.

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Conflict of interest

Lene Mellemkjær has an immediate family member employed at Novo Nordisk, and has an immediate family member who owns stocks in Novo Nordisk. The other authors declare that they have no conflicts of interest.

Ethical approval

In Denmark, approval from the Ethical Committee System is not required for studies that are entirely register based.

Informed consent

In Denmark, written consents are not required for studies that are entirely register based.

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Gottschau, M., Kjær, S.K., Settnes, A. et al. Ovarian removal at or after benign hysterectomy and breast cancer: a nationwide cohort study. Breast Cancer Res Treat 181, 475–485 (2020). https://doi.org/10.1007/s10549-020-05628-z

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  • DOI: https://doi.org/10.1007/s10549-020-05628-z

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