To circumvent confounding factors, Evans et al. reported a significanly improved OS (HR 0.37, 95%CI 0.17–0.8) in 105 unilateral breast cancer patients with germline BRCA1/2 mutations who underwent CRRM were compared to 105 specifically matched controls, the OS improvement is still significant after adjusted for risk-reduction bilateral salpingo-oophorectomy (HR 0.43, 95%CI 0.2–0.95). The gene discussed is BRCA1; the disease is breast carcinoma.