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Clinical Studies

Breast cancer incidence and subtype patterns among BRCA-mutated ovarian cancer patients: a systematic review and meta-analysis

British Journal of Cancer (2025)Cite this article

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Abstract

Background

BRCA1 and BRCA2 are tumor suppressor genes essential for DNA repair. Mutations in these genes significantly increase breast (BC) and ovarian cancer (OC) risk, with BRCA1-positive facing a 70% BC and 40% OC lifetime risk. While guidelines for BRCA-positive are well established, recommendations for BC surveillance in BRCA-patients already diagnosed with OC remain limited. This meta-analysis evaluates BC risk post-OC in BRCA-mutated women.

Methods

A systematic search of PubMed, Embase, and the Cochrane Library was performed. Single-arm outcomes were pooled using meta-analysis of proportions, and survival data were synthesized using hazard ratio (HR), both with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. All analyses were conducted in R (version 4.3.2).

Results

A total of 2380 patients from 10 retrospective cohort studies were included. Among them, 181 (8%; 95% CI: 6%–11%) developed BC post-OC, with similar rates observed for BRCA1 and BRCA2-mutated (9%; 95% CI: 7%–12%). In overall survival analysis, BRCA-mutated patients who developed BC after OC had significantly improved outcomes compared to those with OC only (HR = 0.4657; P < 0.001).

Conclusion

This meta-analysis underscores the need for tailored BC surveillance and evidence-based screening guidelines in BRCA-mutated OC survivors.

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Fig. 1
Fig. 2: Breast cancer Incidence post-OC in patients with BRCA-mutated.
Fig. 3: Overall survival in BRCA-mutated: breast cancer following ovarian cancer versus ovarian cancer only.
Fig. 4: Incidence of breast cancer post-OC according to the diagnostic method of BC.
Fig. 5: Incidence of breast cancer post-OC according to the subtype of BC.

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Data availability

More data can be accessed upon request to the corresponding author. Pedro Henrique de Souza Wagner had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Funding

Design and conduct of the study: No funding. Collection, management, analysis, and interpretation of the data: No funding. Preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication: No funding.

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Authors and Affiliations

  1. Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil

    Pedro Henrique de Souza Wagner

  2. Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil

    Gustavo Tadeu Freitas Uchôa Matheus

  3. University Anhembi Morumbi, Piracicaba, São Paulo, Brazil

    Danilo Monteiro Ribeiro

  4. Mackenzie Evangelical University Hospital, Curitiba, Paraná, Brazil

    Maria Cristina Figueroa Magalhães

  5. Federal University of Pará, Belém, Pará, Brazil

    Francisco Cezar Aquino de Moraes

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  1. Pedro Henrique de Souza Wagner
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  4. Maria Cristina Figueroa Magalhães
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  5. Francisco Cezar Aquino de Moraes
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Contributions

All authors contributed to the study conception and design. [FCAM] conceived the project; material preparation was performed by [PHSW and GTFUM]. Data collection and analysis were performed by [PHSW, GTFUM, and DMR]. The figures and tables were created by [PHSW]. The first draft of the manuscript was written by [PHSW, GTFUM, DMR, MCFM, and FCAM], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pedro Henrique de Souza Wagner.

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Competing interests

The authors declare that they have no competing interests that could have influenced the work reported in this manuscript. All authors have reviewed and approved the final version of the manuscript and agree with its submission.

Ethics approval and consent to participate

This study is a systematic review and meta-analysis. All data were obtained exclusively from previously published studies. All methods were performed in accordance with relevant guidelines and regulations. Ethics approval and informed consent were not required, as no new data were collected from human participants or animals. All included studies reported having obtained approval from their respective ethics committees and informed consent from their participants.

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de Souza Wagner, P.H., Matheus, G.T.F.U., Monteiro Ribeiro, D. et al. Breast cancer incidence and subtype patterns among BRCA-mutated ovarian cancer patients: a systematic review and meta-analysis. Br J Cancer (2025). https://doi.org/10.1038/s41416-025-03320-x

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