Contralateral mastectomy improves survival in women with BRCA1/2-associated breast cancer.
AffiliationGenesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK, firstname.lastname@example.org.
MetadataShow full item record
AbstractBRCA1/2 mutation carriers with breast cancer are at high risk of contralateral disease. Such women often elect to have contralateral risk-reducing mastectomy (CRRM) to reduce the likelihood of recurrence. This study considers whether CRRM improves overall survival. 105 female BRCA1/2 mutation carriers with unilateral breast cancer who underwent CRRM were compared to controls (593 mutation carriers and 105 specifically matched) not undergoing CRRM and diagnosed between 1985 and 2010. Survival was assessed by proportional hazards models, and extended to a matched analysis using stratification by risk-reducing bilateral salpingo-oophorectomy (RRBSO), gene, grade and stage. Median time to CRRM was 1.1 years after the primary diagnosis (range 0.0-13.3). Median follow-up was 9.7 years in the CRRM group and 8.6 in the non-CRRM group. The 10-year overall survival was 89 % in women electing for CRRM (n = 105) compared to 71 % in the non-CRRM group (n = 593); p < 0.001. The survival advantage remained after matching for oophorectomy, gene, grade and stage: HR 0.37 (0.17-0.80, p = 0.008)-CRRM appeared to act independently of RRBSO. CRRM appears to confer a survival advantage. If this finding is confirmed in a larger series it should form part of the counselling procedure at diagnosis of the primary tumour. The indication for CRRM in women who have had RRBSO also requires further research.
CitationContralateral mastectomy improves survival in women with BRCA1/2-associated breast cancer. 2013, 140 (1):135-42 Breast Cancer Res Treat
JournalBreast Cancer Research and Treatment
- Contralateral risk-reducing mastectomy in BRCA1 and BRCA2 mutation carriers and other high-risk women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab).
- Authors: Kiely BE, Jenkins MA, McKinley JM, Friedlander ML, Weideman P, Milne RL, McLachlan SA, Hopper JL, Phillips KA
- Issue date: 2010 Apr
- Improved overall survival after contralateral risk-reducing mastectomy in BRCA1/2 mutation carriers with a history of unilateral breast cancer: a prospective analysis.
- Authors: Heemskerk-Gerritsen BA, Rookus MA, Aalfs CM, Ausems MG, Collée JM, Jansen L, Kets CM, Keymeulen KB, Koppert LB, Meijers-Heijboer HE, Mooij TM, Tollenaar RA, Vasen HF, HEBON., Hooning MJ, Seynaeve C
- Issue date: 2015 Feb 1
- Contralateral risk-reducing mastectomy in young breast cancer patients with and without genetic cancer risk assessment.
- Authors: Mai PL, Lagos VI, Palomares MR, Weitzel JN
- Issue date: 2008 Dec
- Risk-reducing mastectomy for the prevention of primary breast cancer.
- Authors: Carbine NE, Lostumbo L, Wallace J, Ko H
- Issue date: 2018 Apr 5
- Contralateral mastectomy and survival after breast cancer in carriers of BRCA1 and BRCA2 mutations: retrospective analysis.
- Authors: Metcalfe K, Gershman S, Ghadirian P, Lynch HT, Snyder C, Tung N, Kim-Sing C, Eisen A, Foulkes WD, Rosen B, Sun P, Narod SA
- Issue date: 2014 Feb 11