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Pathology of breast and ovarian cancers among BRCA1 and BRCA2 mutation carriers : results from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA)

Mavaddat, Nasim; Barrowdale, Daniel; Andrulis, Irene L; Domchek, Susan M; Eccles, Diana; Nevanlinna, Heli; Ramus, Susan J; Spurdle, Amanda; Robson, Mark and Sherman, Mark, et al. (2012) In Cancer Epidemiology Biomarkers & Prevention 21(1). p.47-134
Abstract

BACKGROUND: Previously, small studies have found that BRCA1 and BRCA2 breast tumors differ in their pathology. Analysis of larger datasets of mutation carriers should allow further tumor characterization.

METHODS: We used data from 4,325 BRCA1 and 2,568 BRCA2 mutation carriers to analyze the pathology of invasive breast, ovarian, and contralateral breast cancers.

RESULTS: There was strong evidence that the proportion of estrogen receptor (ER)-negative breast tumors decreased with age at diagnosis among BRCA1 (P-trend = 1.2 × 10(-5)), but increased with age at diagnosis among BRCA2, carriers (P-trend = 6.8 × 10(-6)). The proportion of triple-negative tumors decreased with age at diagnosis in BRCA1 carriers but increased with... (More)

BACKGROUND: Previously, small studies have found that BRCA1 and BRCA2 breast tumors differ in their pathology. Analysis of larger datasets of mutation carriers should allow further tumor characterization.

METHODS: We used data from 4,325 BRCA1 and 2,568 BRCA2 mutation carriers to analyze the pathology of invasive breast, ovarian, and contralateral breast cancers.

RESULTS: There was strong evidence that the proportion of estrogen receptor (ER)-negative breast tumors decreased with age at diagnosis among BRCA1 (P-trend = 1.2 × 10(-5)), but increased with age at diagnosis among BRCA2, carriers (P-trend = 6.8 × 10(-6)). The proportion of triple-negative tumors decreased with age at diagnosis in BRCA1 carriers but increased with age at diagnosis of BRCA2 carriers. In both BRCA1 and BRCA2 carriers, ER-negative tumors were of higher histologic grade than ER-positive tumors (grade 3 vs. grade 1; P = 1.2 × 10(-13) for BRCA1 and P = 0.001 for BRCA2). ER and progesterone receptor (PR) expression were independently associated with mutation carrier status [ER-positive odds ratio (OR) for BRCA2 = 9.4, 95% CI: 7.0-12.6 and PR-positive OR = 1.7, 95% CI: 1.3-2.3, under joint analysis]. Lobular tumors were more likely to be BRCA2-related (OR for BRCA2 = 3.3, 95% CI: 2.4-4.4; P = 4.4 × 10(-14)), and medullary tumors BRCA1-related (OR for BRCA2 = 0.25, 95% CI: 0.18-0.35; P = 2.3 × 10(-15)). ER-status of the first breast cancer was predictive of ER-status of asynchronous contralateral breast cancer (P = 0.0004 for BRCA1; P = 0.002 for BRCA2). There were no significant differences in ovarian cancer morphology between BRCA1 and BRCA2 carriers (serous: 67%; mucinous: 1%; endometrioid: 12%; clear-cell: 2%). CONCLUSIONS/IMPACT: Pathologic characteristics of BRCA1 and BRCA2 tumors may be useful for improving risk-prediction algorithms and informing clinical strategies for screening and prophylaxis.

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Adult, Aged, Breast Neoplasms, Female, Genes, BRCA1, Genes, BRCA2, Genetic Predisposition to Disease, Germ-Line Mutation, Humans, Middle Aged, Neoplasm Grading, Ovarian Neoplasms
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Cancer Epidemiology Biomarkers & Prevention
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21
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14 pages
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American Association for Cancer Research
external identifiers
  • scopus:84862907494
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1538-7755
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English
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ebb8db3b-5f49-4b58-8255-f3784d119d3b
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2016-09-18 12:06:04
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@article{ebb8db3b-5f49-4b58-8255-f3784d119d3b,
  abstract     = {<p>BACKGROUND: Previously, small studies have found that BRCA1 and BRCA2 breast tumors differ in their pathology. Analysis of larger datasets of mutation carriers should allow further tumor characterization.</p><p>METHODS: We used data from 4,325 BRCA1 and 2,568 BRCA2 mutation carriers to analyze the pathology of invasive breast, ovarian, and contralateral breast cancers.</p><p>RESULTS: There was strong evidence that the proportion of estrogen receptor (ER)-negative breast tumors decreased with age at diagnosis among BRCA1 (P-trend = 1.2 × 10(-5)), but increased with age at diagnosis among BRCA2, carriers (P-trend = 6.8 × 10(-6)). The proportion of triple-negative tumors decreased with age at diagnosis in BRCA1 carriers but increased with age at diagnosis of BRCA2 carriers. In both BRCA1 and BRCA2 carriers, ER-negative tumors were of higher histologic grade than ER-positive tumors (grade 3 vs. grade 1; P = 1.2 × 10(-13) for BRCA1 and P = 0.001 for BRCA2). ER and progesterone receptor (PR) expression were independently associated with mutation carrier status [ER-positive odds ratio (OR) for BRCA2 = 9.4, 95% CI: 7.0-12.6 and PR-positive OR = 1.7, 95% CI: 1.3-2.3, under joint analysis]. Lobular tumors were more likely to be BRCA2-related (OR for BRCA2 = 3.3, 95% CI: 2.4-4.4; P = 4.4 × 10(-14)), and medullary tumors BRCA1-related (OR for BRCA2 = 0.25, 95% CI: 0.18-0.35; P = 2.3 × 10(-15)). ER-status of the first breast cancer was predictive of ER-status of asynchronous contralateral breast cancer (P = 0.0004 for BRCA1; P = 0.002 for BRCA2). There were no significant differences in ovarian cancer morphology between BRCA1 and BRCA2 carriers (serous: 67%; mucinous: 1%; endometrioid: 12%; clear-cell: 2%). CONCLUSIONS/IMPACT: Pathologic characteristics of BRCA1 and BRCA2 tumors may be useful for improving risk-prediction algorithms and informing clinical strategies for screening and prophylaxis.</p>},
  author       = {Mavaddat, Nasim and Barrowdale, Daniel and Andrulis, Irene L and Domchek, Susan M and Eccles, Diana and Nevanlinna, Heli and Ramus, Susan J and Spurdle, Amanda and Robson, Mark and Sherman, Mark and Mulligan, Anna Marie and Couch, Fergus J and Engel, Christoph and McGuffog, Lesley and Healey, Sue and Sinilnikova, Olga M and Southey, Melissa C and Terry, Mary Beth and Goldgar, David and O'Malley, Frances and John, Esther M and Janavicius, Ramunas and Tihomirova, Laima and Hansen, Thomas V O and Nielsen, Finn C and Osorio, Ana and Stavropoulou, Alexandra and Benítez, Javier and Manoukian, Siranoush and Peissel, Bernard and Barile, Monica and Volorio, Sara and Pasini, Barbara and Dolcetti, Riccardo and Putignano, Anna Laura and Ottini, Laura and Radice, Paolo and Hamann, Ute and Rashid, Muhammad U and Hogervorst, Frans B and Kriege, Mieke and van der Luijt, Rob B and Peock, Susan and Frost, Debra and Evans, D Gareth and Brewer, Carole and Walker, Lisa and Rogers, Mark T and Side, Lucy E and Henriksson, Karin and , },
  issn         = {1538-7755},
  keyword      = {Adult,Aged,Breast Neoplasms,Female,Genes, BRCA1,Genes, BRCA2,Genetic Predisposition to Disease,Germ-Line Mutation,Humans,Middle Aged,Neoplasm Grading,Ovarian Neoplasms},
  language     = {eng},
  number       = {1},
  pages        = {47--134},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers & Prevention},
  title        = {Pathology of breast and ovarian cancers among BRCA1 and BRCA2 mutation carriers : results from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA)},
  url          = {http://dx.doi.org/},
  volume       = {21},
  year         = {2012},
}