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High risk of in-breast tumor recurrence after BRCA1/2-associated breast cancer.

Nilsson, Martin LU ; Werner Hartman, Linda LU ; Kristoffersson, Ulf LU ; Johannsson, Oskar Thor LU ; Borg, Åke LU ; Henriksson, Karin LU ; Lanke, Elsa LU ; Olsson, Håkan LU and Loman, Niklas LU (2014) In Breast Cancer Research and Treatment 147(3). p.571-578
Abstract
The purpose of the study was to compare breast-conserving therapy (BCT) and mastectomy (M) in BRCA1/2 mutation carriers. Women with invasive breast cancer and a pathogenic mutation in BRCA1 or BRCA2 were included in the study (n = 162). Patients treated with BCT (n = 45) were compared with patients treated with M (n = 118). Endpoints were local recurrence as first recurrence (LR), overall survival (OS), breast cancer death, and distant recurrence. Cumulative incidence was calculated in the presence of competing risks. For calculation of hazard ratios and for multivariable analysis, cause-specific Cox proportional hazards regression was used. Compared to M, BCT was associated with an increased risk of LR in univariable analysis (HR 4.0; 95... (More)
The purpose of the study was to compare breast-conserving therapy (BCT) and mastectomy (M) in BRCA1/2 mutation carriers. Women with invasive breast cancer and a pathogenic mutation in BRCA1 or BRCA2 were included in the study (n = 162). Patients treated with BCT (n = 45) were compared with patients treated with M (n = 118). Endpoints were local recurrence as first recurrence (LR), overall survival (OS), breast cancer death, and distant recurrence. Cumulative incidence was calculated in the presence of competing risks. For calculation of hazard ratios and for multivariable analysis, cause-specific Cox proportional hazards regression was used. Compared to M, BCT was associated with an increased risk of LR in univariable analysis (HR 4.0; 95 % CI 1.6-9.8) and in multivariable analysis adjusting for tumor stage, age, and use of adjuvant chemotherapy (HR 2.9; CI 1.1-7.8). Following M, all local recurrences were seen in the first 5 years after breast cancer diagnosis. Following BCT, the rate of LR continued to be high also after the first 5 years. The cumulative incidence of LR in the BCT group was 15, 25, and 32 % after 5, 10, and 15 years, respectively. There were no significant differences between BCT and M for OS, breast cancer death, or distant recurrence. BRCA1/2 mutation carriers treated with BCT have a high risk of LR, many of which are new primary breast cancers. This must be thoroughly discussed with the patient and is an example of how rapid treatment-focused genetic testing could influence choice of treatment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Breast Cancer Research and Treatment
volume
147
issue
3
pages
571 - 578
publisher
Springer
external identifiers
  • pmid:25187270
  • wos:000342436200010
  • scopus:84918548920
ISSN
1573-7217
DOI
10.1007/s10549-014-3115-3
language
English
LU publication?
yes
id
ddb1af8c-99d0-4bf4-b185-ef92945b2b79 (old id 4692376)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25187270?dopt=Abstract
date added to LUP
2014-10-01 17:49:55
date last changed
2017-10-01 03:05:27
@article{ddb1af8c-99d0-4bf4-b185-ef92945b2b79,
  abstract     = {The purpose of the study was to compare breast-conserving therapy (BCT) and mastectomy (M) in BRCA1/2 mutation carriers. Women with invasive breast cancer and a pathogenic mutation in BRCA1 or BRCA2 were included in the study (n = 162). Patients treated with BCT (n = 45) were compared with patients treated with M (n = 118). Endpoints were local recurrence as first recurrence (LR), overall survival (OS), breast cancer death, and distant recurrence. Cumulative incidence was calculated in the presence of competing risks. For calculation of hazard ratios and for multivariable analysis, cause-specific Cox proportional hazards regression was used. Compared to M, BCT was associated with an increased risk of LR in univariable analysis (HR 4.0; 95 % CI 1.6-9.8) and in multivariable analysis adjusting for tumor stage, age, and use of adjuvant chemotherapy (HR 2.9; CI 1.1-7.8). Following M, all local recurrences were seen in the first 5 years after breast cancer diagnosis. Following BCT, the rate of LR continued to be high also after the first 5 years. The cumulative incidence of LR in the BCT group was 15, 25, and 32 % after 5, 10, and 15 years, respectively. There were no significant differences between BCT and M for OS, breast cancer death, or distant recurrence. BRCA1/2 mutation carriers treated with BCT have a high risk of LR, many of which are new primary breast cancers. This must be thoroughly discussed with the patient and is an example of how rapid treatment-focused genetic testing could influence choice of treatment.},
  author       = {Nilsson, Martin and Werner Hartman, Linda and Kristoffersson, Ulf and Johannsson, Oskar Thor and Borg, Åke and Henriksson, Karin and Lanke, Elsa and Olsson, Håkan and Loman, Niklas},
  issn         = {1573-7217},
  language     = {eng},
  number       = {3},
  pages        = {571--578},
  publisher    = {Springer},
  series       = {Breast Cancer Research and Treatment},
  title        = {High risk of in-breast tumor recurrence after BRCA1/2-associated breast cancer.},
  url          = {http://dx.doi.org/10.1007/s10549-014-3115-3},
  volume       = {147},
  year         = {2014},
}