Abstract
BACKGROUND: In breast cancer (BC) patients a cancer predisposing BRCA1/2 mutation is associated with adverse tumor characteristics, risk assessment and treatment allocation. We aimed to estimate overall- (OS) and disease-free survival (DFS) according to tumor characteristics and treatment among women who within two years of definitive surgery for primary BC were shown to carry a mutation in BRCA1/2 .
MATERIAL AND METHODS: From the clinical database of the Danish Breast Cancer Group we included 141 BRCA1 and 96 BRCA2 BC patients. Estrogen receptor and HER2 status were centrally reviewed on paraffin-embedded tumor tissue. Information on risk reducing surgery was obtained from the Danish Pathology and Patient Registries and included as time-dependent variables in Cox proportional hazard models.
RESULTS: Ten-year OS and DFS for BRCA1 BC patients were 78% (95% CI 69-85) and 74% (95% CI 64-81). Ten-year OS and DFS for BRCA2 BC were 88% (95% CI 78-94) and 84% (95% CI 74-91). BRCA1 BC patients as compared to BRCA2 BC patients had a higher risk of BC relapse or non-breast cancer within ten years of follow-up, independent of ER status (adjusted HR 2.78 95% CI 1.28-6.05, p = .01), but BRCA mutation was not associated with OS (adjusted HR 1.98, 95% CI 0.87-4.52, p = .10). In multivariate analysis, including both BRCA1 and BRCA2 carriers, no chemotherapy was associated with a higher risk of death (adjusted OS HR 3.58, 95% CI 1.29-9.97, p = .01) and risk reducing contralateral mastectomy (RRCM) was associated with a significantly reduced risk of death (adjusted OS HR 0.42, 95% CI =0.21-0.84, p = .01).
CONCLUSION: Difference in OS between BRCA1 and BRCA2 BC patients could be ascribed to tumor-biology. BRCA1 BC patients may have a shorter ten-year DFS than BRCA2 BC patients. Chemotherapy and risk reducing contralateral mastectomy reduce mortality for both BRCA1 and BRCA2 BC patients.
Original language | English |
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Journal | Acta Oncologica |
Volume | 57 |
Issue number | 1 |
Pages (from-to) | 95-101 |
Number of pages | 7 |
ISSN | 0284-186X |
DOIs | |
Publication status | Published - 2018 |
Event | 16th Acta Oncologica Symposium - Aarhus, Denmark Duration: 18 Jan 2018 → 19 Jan 2018 |
Conference
Conference | 16th Acta Oncologica Symposium |
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Country/Territory | Denmark |
City | Aarhus |
Period | 18/01/2018 → 19/01/2018 |
Keywords
- Adolescent
- Adult
- Aged
- BRCA1 Protein/genetics
- BRCA2 Protein/genetics
- Breast Neoplasms/genetics
- Chemotherapy, Adjuvant
- Denmark/epidemiology
- Disease-Free Survival
- Female
- Genetic Predisposition to Disease
- Heterozygote
- Humans
- Mastectomy
- Middle Aged
- Mutation
- Neoplasm Recurrence, Local/genetics
- Registries
- Young Adult