A Case of Recurrent Breast Cancer Undergoing Risk-reducing Salpingo-oophorectomy Owing to Long-term Complete Response to Olaparib

Abstract

Risk-reducing salpingo-oophorectomy (RRSO) and risk-reducing mastectomy (RRM) have been shown to reduce the risk of cancer in patients previously diagnosed with breast cancer who have BRCA pathogenic variants and were covered by insurance in Japan in 2020. Risk-reducing surgery is generally performed at the time of primary breast cancer surgery or during the postoperative follow-up. However, the efficacy of RRSO and RRM in the treatment of metastatic recurrent breast cancer remains unclear. The approval of olaparib in Japan in 2018 is expected to improve the prognosis of metastatic recurrent breast cancer with BRCA pathological variants, and long-term response has been achieved in some cases. However, the number of patients eligible for olaparib is small, and there are few case reports on long-term treatment, RRSO, and RRM in patients with a long-term response. We herein report our experience with RRSO and RRM in a patient who achieved long-term complete response to olaparib at our hospital. To date, the patient has been on olaparib for 9 years and 4 months, and to the best of our knowledge, this is the longest reported survival period worldwide.