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Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status

Olafsdottir, Elinborg J. ; Borg, Ake LU ; Jensen, Maj Britt ; Gerdes, Anne Marie ; Johansson, Anna L.V. ; Barkardottir, Rosa B ; Johannsson, Oskar T. LU ; Ejlertsen, Bent ; Sønderstrup, Ida Marie Heeholm and Hovig, Eivind , et al. (2020) In British Journal of Cancer 123(11). p.1608-1615
Abstract

Background: The natural history of breast cancer among BRCA2 carriers has not been clearly established. In a previous study from Iceland, positive ER status was a negative prognostic factor. We sought to identify factors that predicted survival after invasive breast cancer in an expanded cohort of BRCA2 carriers. Methods: We studied 608 women with invasive breast cancer and a pathogenic BRCA2 mutation (variant) from four Nordic countries. Information on prognostic factors and treatment was retrieved from health records and by analysis of archived tissue specimens. Hazard ratios (HR) were estimated for breast cancer-specific survival using Cox regression. Results: About 77% of cancers were ER-positive, with the highest proportion (83%)... (More)

Background: The natural history of breast cancer among BRCA2 carriers has not been clearly established. In a previous study from Iceland, positive ER status was a negative prognostic factor. We sought to identify factors that predicted survival after invasive breast cancer in an expanded cohort of BRCA2 carriers. Methods: We studied 608 women with invasive breast cancer and a pathogenic BRCA2 mutation (variant) from four Nordic countries. Information on prognostic factors and treatment was retrieved from health records and by analysis of archived tissue specimens. Hazard ratios (HR) were estimated for breast cancer-specific survival using Cox regression. Results: About 77% of cancers were ER-positive, with the highest proportion (83%) in patients under 40 years. ER-positive breast cancers were more likely to be node-positive (59%) than ER-negative cancers (34%) (P < 0.001). The survival analysis included 584 patients. Positive ER status was protective in the first 5 years from diagnosis (multivariate HR = 0.49; 95% CI 0.26–0.93, P = 0.03); thereafter, the effect was adverse (HR = 1.91; 95% CI 1.07–3.39, P = 0.03). The adverse effect of positive ER status was limited to women who did not undergo endocrine treatment (HR = 2.36; 95% CI 1.26–4.44, P = 0.01) and patients with intact ovaries (HR = 1.99; 95% CI 1.11–3.59, P = 0.02). Conclusions: The adverse effect of a positive ER status in BRCA2 carriers with breast cancer may be contingent on exposure to ovarian hormones.

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type
Contribution to journal
publication status
published
subject
in
British Journal of Cancer
volume
123
issue
11
pages
8 pages
publisher
Nature Publishing Group
external identifiers
  • scopus:85091156088
  • pmid:32939053
ISSN
0007-0920
DOI
10.1038/s41416-020-01056-4
language
English
LU publication?
yes
id
0b4cc50f-f6df-4cff-a226-c48768744d93
date added to LUP
2020-11-02 11:46:35
date last changed
2021-01-06 08:31:38
@article{0b4cc50f-f6df-4cff-a226-c48768744d93,
  abstract     = {<p>Background: The natural history of breast cancer among BRCA2 carriers has not been clearly established. In a previous study from Iceland, positive ER status was a negative prognostic factor. We sought to identify factors that predicted survival after invasive breast cancer in an expanded cohort of BRCA2 carriers. Methods: We studied 608 women with invasive breast cancer and a pathogenic BRCA2 mutation (variant) from four Nordic countries. Information on prognostic factors and treatment was retrieved from health records and by analysis of archived tissue specimens. Hazard ratios (HR) were estimated for breast cancer-specific survival using Cox regression. Results: About 77% of cancers were ER-positive, with the highest proportion (83%) in patients under 40 years. ER-positive breast cancers were more likely to be node-positive (59%) than ER-negative cancers (34%) (P &lt; 0.001). The survival analysis included 584 patients. Positive ER status was protective in the first 5 years from diagnosis (multivariate HR = 0.49; 95% CI 0.26–0.93, P = 0.03); thereafter, the effect was adverse (HR = 1.91; 95% CI 1.07–3.39, P = 0.03). The adverse effect of positive ER status was limited to women who did not undergo endocrine treatment (HR = 2.36; 95% CI 1.26–4.44, P = 0.01) and patients with intact ovaries (HR = 1.99; 95% CI 1.11–3.59, P = 0.02). Conclusions: The adverse effect of a positive ER status in BRCA2 carriers with breast cancer may be contingent on exposure to ovarian hormones.</p>},
  author       = {Olafsdottir, Elinborg J. and Borg, Ake and Jensen, Maj Britt and Gerdes, Anne Marie and Johansson, Anna L.V. and Barkardottir, Rosa B and Johannsson, Oskar T. and Ejlertsen, Bent and Sønderstrup, Ida Marie Heeholm and Hovig, Eivind and Lænkholm, Anne Vibeke and Hansen, Thomas van Overeem and Olafsdottir, Gudridur H. and Rossing, Maria and Jonasson, Jon G. and Sigurdsson, Stefan and Loman, Niklas and Nilsson, Martin P. and Narod, Steven A. and Tryggvadottir, Laufey},
  issn         = {0007-0920},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1608--1615},
  publisher    = {Nature Publishing Group},
  series       = {British Journal of Cancer},
  title        = {Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status},
  url          = {http://dx.doi.org/10.1038/s41416-020-01056-4},
  doi          = {10.1038/s41416-020-01056-4},
  volume       = {123},
  year         = {2020},
}