Survival from breast cancer in women with a BRCA2 mutation by treatment

Evans, DG; Phillips, KA; Milne, RL; Fruscio, R; Cybulski, C; Gronwald, J; Lubinski, J; Huzarski, T; Hyder, Z; Forde, C; Metcalfe, K; Senter, L; Weitzel, J; Tung, N; Zakalik, D; Ekholm, M; Sun, P; Narod, SA; kConFab Investigators; Polish Hereditary Breast Cancer Consortium; Hereditary Breast Cancer Clinical Study Group; Other members of the Polish Hereditary Breast Cancer Consortium; Other members of the kConFab Follow-Up Study Team; Other members of Hereditary Breast Cancer Clinical Study Group

Author(s): Evans, DG; Phillips, KA; Milne, RL; Fruscio, R; Cybulski, C; Gronwald, J; Lubinski, J; Huzarski, T; Hyder, Z; Forde, C; Metcalfe, K; Senter, L; Weitzel, J; Tung, N; Zakalik, D; Ekholm, M; Sun, P; Narod, SA; kConFab Investigators; Polish Hereditary Breast Cancer Consortium; Hereditary Breast Cancer Clinical Study Group; Other members of the Polish Hereditary Breast Cancer Consortium; Other members of the kConFab Follow-Up Study Team; Other members of Hereditary Breast Cancer Clinical Study Group;
Details: Publication Year 2021-04,Volume 124,Issue #9,Page 1524-1532
Journal Title: British Journal of Cancer
Publication Type: Research article
Abstract: BACKGROUND: The impact of various breast-cancer treatments on patients with a BRCA2 mutation has not been studied. We sought to estimate the impact of bilateral oophorectomy and other treatments on breast cancer-specific survival among patients with a germline BRCA2 mutation. METHODS: We identified 664 women with stage I-III breast cancer and a BRCA2 mutation by combining five different datasets (retrospective and prospective). Subjects were followed for 7.2 years from diagnosis to death from breast cancer. Tumour characteristics and cancer treatments were patient-reported and derived from medical records. Predictors of survival were determined using Cox proportional hazard models, adjusted for other treatments and for prognostic features. RESULTS: The 10-year breast-cancer survival for ER-positive patients was 78.9% and for ER-negative patients was 82.3% (adjusted HR = 1.23 (95% CI, 0.62-2.45, p = 0.55)). The 10-year breast-cancer survival for women who had a bilateral oophorectomy was 89.1% and for women who did not have an oophorectomy was 59.0% (adjusted HR = 0.45; 95% CI, 0.28-0.72, p = 0.001). The adjusted hazard ratio for chemotherapy was 0.83 (95% CI, 0.65-1.53: p = 0.56). CONCLUSIONS: For women with breast cancer and a germline BRCA2 mutation, positive ER status does not predict superior survival. Oophorectomy is associated with a reduced risk of death from breast cancer and should be considered in the treatment plan.
Keywords: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; BRCA1 Protein/genetics; BRCA2 Protein/*genetics; Biomarkers, Tumor/genetics/metabolism; Breast Neoplasms/genetics/*mortality/pathology/therapy; Combined Modality Therapy; Female; Follow-Up Studies; *Germ-Line Mutation; Humans; Mastectomy/*mortality; Middle Aged; Ovariectomy/*mortality; Prognosis; Prospective Studies; Radiotherapy/*mortality; Receptor, ErbB-2/metabolism; Receptors, Estrogen/metabolism; Receptors, Progesterone/metabolism; Retrospective Studies; Survival Rate
Department(s): Medical Oncology; Laboratory Research
PubMed ID: 33597716
Publisher's Version: https://doi.org/10.1038/s41416-020-01164-1
Open Access at Publisher's Site: https://doi.org/10.1038/s41416-020-01164-1
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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