Long-term prognosis of early-onset breast cancer in a population-based cohort with a known BRCA1/2 mutation status.
(2014) In Breast Cancer Research and Treatment 144(1). p.133-142- Abstract
- All women in the South Sweden Health Care Region with breast cancer diagnosed aged less than 41 during the period between 1990 and 1995 were contacted in 1996 and offered germline mutation analysis of the BRCA1 and BRCA2 genes. Mutation carriers (n = 20) were compared with noncarriers (n = 201) for overall survival (OS) and risk of contralateral breast cancer (CBC). Mutation carriers were younger at diagnosis and more likely to have ER-negative, PgR-negative and grade III tumors. Median follow-up was 19 years. The 5-, 10-, 15-, and 20-year OS were 60, 45, 39, and 39 % for mutation carriers and 82, 70, 59, and 53 % for noncarriers, respectively (5-year log-rank P = 0.013; 10-year P = 0.008; 15-year P = 0.020; and 20-year P = 0.046). In... (More)
- All women in the South Sweden Health Care Region with breast cancer diagnosed aged less than 41 during the period between 1990 and 1995 were contacted in 1996 and offered germline mutation analysis of the BRCA1 and BRCA2 genes. Mutation carriers (n = 20) were compared with noncarriers (n = 201) for overall survival (OS) and risk of contralateral breast cancer (CBC). Mutation carriers were younger at diagnosis and more likely to have ER-negative, PgR-negative and grade III tumors. Median follow-up was 19 years. The 5-, 10-, 15-, and 20-year OS were 60, 45, 39, and 39 % for mutation carriers and 82, 70, 59, and 53 % for noncarriers, respectively (5-year log-rank P = 0.013; 10-year P = 0.008; 15-year P = 0.020; and 20-year P = 0.046). In univariable analysis, there was a trend for an inferior OS for mutation carriers (HR 1.8; 95 % CI 1.0-3.3). When stratified for use of (neo)adjuvant chemotherapy, an inferior OS was significant only for the subgroup of patients who did not receive chemotherapy (HR 3.0; 95 % CI 1.2-7.7). In multivarible analysis, BRCA1/2 mutation status was a significant predictor of OS when adjusting for tumor stage, age, and use of chemotherapy, but not when ER status was also included in the model. The 15-year cumulative risk of CBC was 53 % for mutation carriers and 10 % for noncarriers (HR 5.9; 95 % CI 1.9-18.6); among the noncarriers the risks were 5, 22, and 30 % for patients without close relatives having breast cancer, with second-degree relatives having breast cancer, and with firstdegree relatives with breast cancer, respectively. In conclusion, the poor prognosis of young BRCA1/2 mutation carriers with breast cancer is mainly explained by the prevalent occurrence of negative prognostic factors rather than mutation status per se, and can to at least some extent be abrogated by the use of chemotherapy. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4286553
- author
- Nilsson, Martin LU ; Werner Hartman, Linda LU ; Idvall, Ingrid LU ; Kristoffersson, Ulf LU ; Johannsson, Oskar T and Loman, Niklas LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Breast Cancer Research and Treatment
- volume
- 144
- issue
- 1
- pages
- 133 - 142
- publisher
- Springer
- external identifiers
-
- pmid:24477976
- wos:000331649300013
- scopus:84894676157
- pmid:24477976
- ISSN
- 1573-7217
- DOI
- 10.1007/s10549-014-2842-9
- language
- English
- LU publication?
- yes
- id
- e767f982-ae09-41ad-8fb2-58f2a5300fbc (old id 4286553)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/24477976?dopt=Abstract
- date added to LUP
- 2016-04-01 10:45:14
- date last changed
- 2022-04-25 12:53:13
@article{e767f982-ae09-41ad-8fb2-58f2a5300fbc,
abstract = {{All women in the South Sweden Health Care Region with breast cancer diagnosed aged less than 41 during the period between 1990 and 1995 were contacted in 1996 and offered germline mutation analysis of the BRCA1 and BRCA2 genes. Mutation carriers (n = 20) were compared with noncarriers (n = 201) for overall survival (OS) and risk of contralateral breast cancer (CBC). Mutation carriers were younger at diagnosis and more likely to have ER-negative, PgR-negative and grade III tumors. Median follow-up was 19 years. The 5-, 10-, 15-, and 20-year OS were 60, 45, 39, and 39 % for mutation carriers and 82, 70, 59, and 53 % for noncarriers, respectively (5-year log-rank P = 0.013; 10-year P = 0.008; 15-year P = 0.020; and 20-year P = 0.046). In univariable analysis, there was a trend for an inferior OS for mutation carriers (HR 1.8; 95 % CI 1.0-3.3). When stratified for use of (neo)adjuvant chemotherapy, an inferior OS was significant only for the subgroup of patients who did not receive chemotherapy (HR 3.0; 95 % CI 1.2-7.7). In multivarible analysis, BRCA1/2 mutation status was a significant predictor of OS when adjusting for tumor stage, age, and use of chemotherapy, but not when ER status was also included in the model. The 15-year cumulative risk of CBC was 53 % for mutation carriers and 10 % for noncarriers (HR 5.9; 95 % CI 1.9-18.6); among the noncarriers the risks were 5, 22, and 30 % for patients without close relatives having breast cancer, with second-degree relatives having breast cancer, and with firstdegree relatives with breast cancer, respectively. In conclusion, the poor prognosis of young BRCA1/2 mutation carriers with breast cancer is mainly explained by the prevalent occurrence of negative prognostic factors rather than mutation status per se, and can to at least some extent be abrogated by the use of chemotherapy.}},
author = {{Nilsson, Martin and Werner Hartman, Linda and Idvall, Ingrid and Kristoffersson, Ulf and Johannsson, Oskar T and Loman, Niklas}},
issn = {{1573-7217}},
language = {{eng}},
number = {{1}},
pages = {{133--142}},
publisher = {{Springer}},
series = {{Breast Cancer Research and Treatment}},
title = {{Long-term prognosis of early-onset breast cancer in a population-based cohort with a known BRCA1/2 mutation status.}},
url = {{http://dx.doi.org/10.1007/s10549-014-2842-9}},
doi = {{10.1007/s10549-014-2842-9}},
volume = {{144}},
year = {{2014}},
}