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Ten-Year Survival in Patients With BRCA1 -Negative and BRCA1 -Positive Breast Cancer

2013; Lippincott Williams & Wilkins; Volume: 31; Issue: 26 Linguagem: Inglês

10.1200/jco.2012.45.3571

1527-7755

Tomasz Huzarski, Tomasz Byrski, Jacek Gronwald, Bohdan Górski, Paweł Domagała, Cezary Cybulski, Oleg Oszurek, Marek Szwiec, K Gugała, Małgorzata Stawicka, Zbigniew Morawiec, Tomasz Mierzwa, Hanna Janiszewska, Ewa Kilar, Elżbieta Marczyk, Beata Kozak‐Klonowska, Monika Siołek, Dariusz Surdyka, Rafał Wiśniowski, Michał Posmyk, Ping Sun, Jan Lubiński, Steven A. Narod,

DNA Repair Mechanisms

To estimate 10-year overall survival (OS) rates for patients with early-onset breast cancer, with and without a BRCA1 mutation, and to identify prognostic factors among those with BRCA1-positive breast cancer.A total of 3,345 women with stage I to III breast cancer, age ≤ 50 years, were tested for three founder mutations in BRCA1. Information on tumor characteristics and treatments received was retrieved from medical records. Dates of death were obtained from the vital statistics registry. Survival curves for the mutation-positive and -negative subcohorts were compared. Predictors of OS were determined using the Cox proportional hazards model.Of the 3,345 patients enrolled onto the study, 233 (7.0%) carried a BRCA1 mutation. The 10-year survival rate for mutation carriers was 80.9% (95% CI, 75.4% to 86.4%); for noncarriers, it was 82.2% (95% CI, 80.5% to 83.7%). The adjusted hazard ratio (HR) associated with carrying a BRCA1 mutation was 1.81 (95% CI, 1.26 to 2.61). Among BRCA1 carriers with a small (< 2 cm) node-negative tumor, the 10-year survival rate was 89.9%. Among BRCA1 mutation carriers, positive lymph node status was a strong predictor of mortality (adjusted HR, 4.1; 95% CI, 1.8 to 8.9). Oophorectomy was associated with improved survival in BRCA1 carriers (adjusted HR, 0.30; 95% CI, 0.12 to 0.75).The 10-year survival rate among women with breast cancer and a BRCA1 mutation is similar to that of patients without a BRCA1 mutation. Among women with a BRCA1 mutation, survival was much improved after oophorectomy.