Characteristics and clinical outcomes of breast cancer in young BRCA carriers according to tumor histology.

BRCA breast cancer histology lobular

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
16 Sep 2024
Historique:
received: 22 03 2024
revised: 11 07 2024
accepted: 19 08 2024
medline: 18 9 2024
pubmed: 18 9 2024
entrez: 17 9 2024
Statut: aheadofprint

Résumé

Young women with breast cancer (BC) have an increased chance of carrying germline BRCA pathogenic variants (PVs). Limited data exist on the prognostic impact of tumor histology (i.e. ductal versus lobular) in hereditary breast cancer. This multicenter retrospective cohort study included women aged ≤40 years with early-stage breast cancer diagnosed between January 2000 and December 2020 and known to carry germline PVs in BRCA1/2. Histology was locally assessed in each center. The Kaplan-Meier method and Cox regression analysis were used to assess disease-free survival and overall survival. Of 4628 patients included from 78 centers worldwide, 3969 (86%) had pure ductal, 135 (3%) pure lobular, and 524 (11%) other histologies. Compared with ductal tumors, lobular tumors were more often grade 1/2 (57.7% versus 22.1%), stage III (29.6% versus 18.5%), and luminal A-like (42.2% versus 12.2%). Lobular tumors were more often associated with BRCA2 PVs (71.1% BRCA2), while ductal tumors were more often associated with BRCA1 PVs (65.7% BRCA1). Patients with lobular tumors more often had mastectomy (68.9% versus 58.3%), and less often received chemotherapy (83.7% versus 92.9%). With a median follow-up of 7.8 years, no significant differences were observed in disease-free survival (adjusted hazard ratio 1.01, 95% confidence interval 0.74-1.37) or overall survival (hazard ratio 0.96, 95% confidence interval 0.62-1.50) between patients with ductal versus lobular tumors. No significant survival differences were observed according to specific BRCA gene, breast cancer subtype, or body mass index. In this large global cohort of young BRCA carriers with breast cancer, the incidence of pure lobular histology was low and associated with higher disease stage at diagnosis, luminal-like disease and BRCA2 PVs. Histology did not appear to impact prognosis.

Sections du résumé

BACKGROUND BACKGROUND
Young women with breast cancer (BC) have an increased chance of carrying germline BRCA pathogenic variants (PVs). Limited data exist on the prognostic impact of tumor histology (i.e. ductal versus lobular) in hereditary breast cancer.
METHODS METHODS
This multicenter retrospective cohort study included women aged ≤40 years with early-stage breast cancer diagnosed between January 2000 and December 2020 and known to carry germline PVs in BRCA1/2. Histology was locally assessed in each center. The Kaplan-Meier method and Cox regression analysis were used to assess disease-free survival and overall survival.
RESULTS RESULTS
Of 4628 patients included from 78 centers worldwide, 3969 (86%) had pure ductal, 135 (3%) pure lobular, and 524 (11%) other histologies. Compared with ductal tumors, lobular tumors were more often grade 1/2 (57.7% versus 22.1%), stage III (29.6% versus 18.5%), and luminal A-like (42.2% versus 12.2%). Lobular tumors were more often associated with BRCA2 PVs (71.1% BRCA2), while ductal tumors were more often associated with BRCA1 PVs (65.7% BRCA1). Patients with lobular tumors more often had mastectomy (68.9% versus 58.3%), and less often received chemotherapy (83.7% versus 92.9%). With a median follow-up of 7.8 years, no significant differences were observed in disease-free survival (adjusted hazard ratio 1.01, 95% confidence interval 0.74-1.37) or overall survival (hazard ratio 0.96, 95% confidence interval 0.62-1.50) between patients with ductal versus lobular tumors. No significant survival differences were observed according to specific BRCA gene, breast cancer subtype, or body mass index.
CONCLUSIONS CONCLUSIONS
In this large global cohort of young BRCA carriers with breast cancer, the incidence of pure lobular histology was low and associated with higher disease stage at diagnosis, luminal-like disease and BRCA2 PVs. Histology did not appear to impact prognosis.

Identifiants

DOI: 10.1016/j.esmoop.2024.103714 PMID: 39288653
pubmed: 39288653
pii: S2059-7029(24)01484-4
doi: 10.1016/j.esmoop.2024.103714
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103714

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

E Agostinetto (E)

Academic Trials Promoting Team, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium. Electronic address: elisa.agostinetto@hubruxelles.be.

M Bruzzone (M)

U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

A-S Hamy (AS)

Department of Medical Oncology, Universite Paris Cité, Institut Curie, Paris, France.

H J Kim (HJ)

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

C Chiodi (C)

Cancer Survivorship Program - Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France.

R Bernstein-Molho (R)

Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center Affiliated to Tel Aviv University, Tel Hashomer, Israel.

S Linn (S)

Department of Molecular Pathology, Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands.

K Pogoda (K)

Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

E Carrasco (E)

Hereditary Cancer Genetics Unit, Medical Oncology Department, Vall d´Hebron University Hospital, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain.

F Derouane (F)

Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.

J Bajpai (J)

Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.

G Nader-Marta (G)

Academic Trials Promoting Team, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium.

N Lopetegui-Lia (N)

Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland.

A H Partridge (AH)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.

L Cortesi (L)

Department of Oncology and Haematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.

C Rousset-Jablonski (C)

Department of Surgery, Leon Berard Cancer Center, Lyon; Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron; Unité INSERM U1290 RESHAPE, Lyon.

F Giugliano (F)

Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

T Renaud (T)

Cancer Genetics Unit, Bergonie Institute, Bordeaux, France.

A Ferrari (A)

Hereditary Breast and Ovarian Cancer (HBOC) Unit and General Surgery 3 - Senology, Surgical Department, Fondazione IRCCS Policlinico San Matteo, Pavia; University of Pavia, Pavia, Italy.

S Paluch-Shimon (S)

Breast Oncology Unit, Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem; Faculty of Medicine, Hebrew University, Jerusalem, Israel.

R Fruscio (R)

UO Gynecology, Fondazione IRCCS San Gerardo, Monza; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.

W Cui (W)

Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria; Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia.

S M Wong (SM)

Stroll Cancer Prevention Centre, Jewish General Hospital, Montreal; McGill University Medical School, Montreal, Canada.

C Vernieri (C)

Medical Oncology Department, Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; Oncology and Hematology-Oncology Department, University of Milan, Milan, Italy.

K J Ruddy (KJ)

Department of Oncology, Mayo Clinic College of Medicine, Rochester, USA.

M V Dieci (MV)

Department of Surgical, Oncological and Gastroenterological Sciences, Università di Padova, Padua; Oncologia 2, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy.

A Matikas (A)

Department of Oncology/Pathology, Karolinska Institute, Stockholm; Breast Center, Karolinska University Hospital, Stockholm, Sweden.

M Rozenblit (M)

Yale University, Medical Oncology, New Haven, USA.

D Aguilar Y Mendez (D)

Tecnologico de Monterrey, Breast Cancer Center, Hospital Zambrano Hellion - TecSalud, Monterrey, Mexico.

L De Marchis (L)

Division of Medical Oncology, Department of Radiological, Oncological and Pathological Sciences, 'La Sapienza' University of Rome, Rome; Oncology Unit, Umberto 1 University Hospital, Rome.

R Borea (R)

Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genoa.

F Puglisi (F)

Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano; Department of Medicine, University of Udine, Udine.

M Pistelli (M)

Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.

J Kufel-Grabowska (J)

Medical University of Gdańsk, Gdańsk, Poland.

R Di Rocco (R)

Department of Medical Oncology, Azienda USL Toscana Sud Est - Misericordia Hospital, Grosseto, Italy.

E Mariamidze (E)

Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa; Department of Oncology and Hematology, Todua Clinic, Tbilisi, Georgia.

F Atzori (F)

Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy.

H R Kourie (HR)

Saint Joseph University of Beirut, Beirut, Lebanon.

L Popovic (L)

Oncology Institute of Vojvodina - Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.

E de Azambuja (E)

Academic Trials Promoting Team, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium.

E Blondeaux (E)

U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

M Lambertini (M)

Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genoa.

Classifications MeSH