Survival from breast cancer in women with a BRCA2 mutation by treatment.
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
BRCA1 Protein
/ genetics
BRCA2 Protein
/ genetics
Biomarkers, Tumor
/ genetics
Breast Neoplasms
/ genetics
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
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
14
07
2020
accepted:
29
10
2020
revised:
20
10
2020
pubmed:
19
2
2021
medline:
28
9
2021
entrez:
18
2
2021
Statut:
ppublish
Résumé
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. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 33597716
doi: 10.1038/s41416-020-01164-1
pii: 10.1038/s41416-020-01164-1
pmc: PMC8076275
doi:
Substances chimiques
BRCA1 Protein
0
BRCA1 protein, human
0
BRCA2 Protein
0
BRCA2 protein, human
0
Biomarkers, Tumor
0
Receptors, Estrogen
0
Receptors, Progesterone
0
ERBB2 protein, human
EC 2.7.10.1
Receptor, ErbB-2
EC 2.7.10.1
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1524-1532Subventions
Organisme : NCI NIH HHS
ID : R01 CA159868
Pays : United States
Investigateurs
Maria Błasińska-Morawiec
(M)
Maria Chosia
(M)
Kazimierz Drosik
(K)
Sylwia Gozdecka-Grodecka
(S)
Stanisław Goźdź
(S)
Ewa Grzybowska
(E)
Arkadiusz Jeziorski
(A)
Aldona Karczewska
(A)
Radzisław Kordek
(R)
Agnieszka Synowiec
(A)
Beata Kozak-Klonowska
(B)
Katarzyna Lamperska
(K)
Dariusz Lange
(D)
Andrzej Mackiewicz
(A)
Jerzy Władysław Mituś
(JW)
Stanislas Niepsuj
(S)
Oleg Oszurek
(O)
Karol Gugała
(K)
Zbigniew Morawiec
(Z)
Tomasz Mierzwa
(T)
Michał Posmyk
(M)
Janusz Ryś
(J)
Cezary Szczylik
(C)
Michał Uciński
(M)
Krzysztof Urbański
(K)
Bernard Waśko
(B)
Piotr Wandzel
(P)
Michael Friedlander
(M)
Sue Anne McLachlan
(SA)
Stephanie Nesci
(S)
Sandra Picken
(S)
Sarah O'Connor
(S)
Lucy Stanhope
(L)
Andrea Eisen
(A)
Kevin Sweet
(K)
Raymond Kim
(R)
William Foulkes
(W)
Pal Moller
(P)
Susan Neuhausen
(S)
Carey Cullinane
(C)
Charis Eng
(C)
Peter Ainsworth
(P)
Fergus Couch
(F)
Christian Singer
(C)
Beth Karlan
(B)
Wendy McKinnon
(W)
Marie Wood
(M)
Commentaires et corrections
Type : ErratumIn
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