Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy.

2.50
Hdl Handle:
http://hdl.handle.net/10541/80118
Title:
Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy.
Authors:
Møller, Pål; Borg, Ake; Evans, D Gareth R; Haites, Neva; Reis, Marta M; Vasen, Hans; Anderson, Elaine; Steel, C Michael; Apold, J; Goudie, David; Howell, Anthony ( 0000-0002-6233-719X ) ; Lalloo, Fiona; Maehle, Lovise; Gregory, Helen; Heimdal, Ketil
Abstract:
Dedicated clinics have been established for the early diagnosis and treatment of women at risk for inherited breast cancer, but the effects of such interventions are currently unproven. This second report on prospectively diagnosed inherited breast cancer from the European collaborating centres supports the previous conclusions and adds information on genetic heterogeneity and the effect of oophorectomy. Of 249 patients, 20% had carcinoma in situ (CIS), 54% had infiltrating cancer without spread (CaN0) and 26% had cancer with spread (CaN+). Five-year survival was 100% for CIS, 94% for CaN0 and 72% for CaN+ (p = 0.007). Thirty-six patients had BRCA1 mutations, and 8 had BRCA2 mutations. Presence of BRCA1 mutation was associated with infiltrating cancer, high grade and lack of oestrogen receptor (p < 0.05 for all 3 characteristics). For BRCA1 mutation carriers, 5-year survival was 63% vs. 91% for noncarriers (p = 0.04). For CaN0 patients, mutation carriers had 75% 5-year disease-free survival vs. 96% for noncarriers (p = 0.01). Twenty-one of the mutation carriers had undergone prophylactic oophorectomy, prior to or within 6 months of diagnosis in 13 cases. All but 1 relapse occurred in the 15 who had kept their ovaries, (p < 0.01); no relapse occurred in those who had removed the ovaries within 6 months (p = 0.04) Contralateral cancer was more frequently observed in mutation noncarriers, but this finding did not reach statistical significance. Our findings support the concept that BRCA1 cancer is biologically different from other inherited breast cancers. While current screening protocols appear satisfactory for the majority of women at risk of familial breast cancer, this may not be the case for BRCA1 mutation carriers. The observed effect of oophorectomy was striking.
Affiliation:
Section of Genetic Counselling, Department of Cancer Genetics, Norwegian Radium Hospital, Oslo, Norway. pal.moller@klinmed.uio.no
Citation:
Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy. 2002, 101 (6):555-9 Int. J. Cancer
Journal:
International Journal of Cancer.
Issue Date:
20-Oct-2002
URI:
http://hdl.handle.net/10541/80118
DOI:
10.1002/ijc.10641
PubMed ID:
12237897
Type:
Article
Language:
en
ISSN:
0020-7136
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMøller, Pål-
dc.contributor.authorBorg, Ake-
dc.contributor.authorEvans, D Gareth R-
dc.contributor.authorHaites, Neva-
dc.contributor.authorReis, Marta M-
dc.contributor.authorVasen, Hans-
dc.contributor.authorAnderson, Elaine-
dc.contributor.authorSteel, C Michael-
dc.contributor.authorApold, J-
dc.contributor.authorGoudie, David-
dc.contributor.authorHowell, Anthony-
dc.contributor.authorLalloo, Fiona-
dc.contributor.authorMaehle, Lovise-
dc.contributor.authorGregory, Helen-
dc.contributor.authorHeimdal, Ketil-
dc.date.accessioned2009-09-07T14:31:32Z-
dc.date.available2009-09-07T14:31:32Z-
dc.date.issued2002-10-20-
dc.identifier.citationSurvival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy. 2002, 101 (6):555-9 Int. J. Canceren
dc.identifier.issn0020-7136-
dc.identifier.pmid12237897-
dc.identifier.doi10.1002/ijc.10641-
dc.identifier.urihttp://hdl.handle.net/10541/80118-
dc.description.abstractDedicated clinics have been established for the early diagnosis and treatment of women at risk for inherited breast cancer, but the effects of such interventions are currently unproven. This second report on prospectively diagnosed inherited breast cancer from the European collaborating centres supports the previous conclusions and adds information on genetic heterogeneity and the effect of oophorectomy. Of 249 patients, 20% had carcinoma in situ (CIS), 54% had infiltrating cancer without spread (CaN0) and 26% had cancer with spread (CaN+). Five-year survival was 100% for CIS, 94% for CaN0 and 72% for CaN+ (p = 0.007). Thirty-six patients had BRCA1 mutations, and 8 had BRCA2 mutations. Presence of BRCA1 mutation was associated with infiltrating cancer, high grade and lack of oestrogen receptor (p < 0.05 for all 3 characteristics). For BRCA1 mutation carriers, 5-year survival was 63% vs. 91% for noncarriers (p = 0.04). For CaN0 patients, mutation carriers had 75% 5-year disease-free survival vs. 96% for noncarriers (p = 0.01). Twenty-one of the mutation carriers had undergone prophylactic oophorectomy, prior to or within 6 months of diagnosis in 13 cases. All but 1 relapse occurred in the 15 who had kept their ovaries, (p < 0.01); no relapse occurred in those who had removed the ovaries within 6 months (p = 0.04) Contralateral cancer was more frequently observed in mutation noncarriers, but this finding did not reach statistical significance. Our findings support the concept that BRCA1 cancer is biologically different from other inherited breast cancers. While current screening protocols appear satisfactory for the majority of women at risk of familial breast cancer, this may not be the case for BRCA1 mutation carriers. The observed effect of oophorectomy was striking.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshBreast Neoplasms-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshGenes, BRCA1-
dc.subject.meshGenes, BRCA2-
dc.subject.meshGenetic Predisposition to Disease-
dc.subject.meshHumans-
dc.subject.meshMiddle Aged-
dc.subject.meshMutation-
dc.subject.meshOvariectomy-
dc.subject.meshSurvival Rate-
dc.subject.meshTime Factors-
dc.titleSurvival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy.en
dc.typeArticleen
dc.contributor.departmentSection of Genetic Counselling, Department of Cancer Genetics, Norwegian Radium Hospital, Oslo, Norway. pal.moller@klinmed.uio.noen
dc.identifier.journalInternational Journal of Cancer.en

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