Effects of Germline Pathogenic Variants, Cancer Subtypes, Tumor-related Characteristics, and Pregnancy-associated Diagnosis on Outcomes.

Autor: Tsai ML; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Knaack M; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Martone P; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Krueger J; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Baldinger SR; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Lillemoe TJ; Hospital Pathology Associates, Allina Health Laboratories, Minneapolis, MN., Susnik B; Hospital Pathology Associates, Allina Health Laboratories, Minneapolis, MN., Grimm E; Hospital Pathology Associates, Allina Health Laboratories, Minneapolis, MN., Olet S; Research Informatics, Allina Health System, Minneapolis, MN., Rueth N; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN., Swenson KK; Allina Health System, Virginia Piper Cancer Institute, Minneapolis, MN. Electronic address: karen.swenson2@allina.com.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2021 Feb; Vol. 21 (1), pp. 47-56. Date of Electronic Publication: 2020 Jul 09.
DOI: 10.1016/j.clbc.2020.07.003
Abstrakt: Background: Although breast cancer (BC) is uncommon in women age ≤ 35 years, women in this age group may have more aggressive cancer subtypes and high-risk pathogenic variants (HRPVs). Higher recurrence and mortality rates in young patients may be related to differences in tumor biology, pathologic mutation status, or treatment. The purpose of this study was to evaluate germline mutation status and other factors that affect recurrence-free survival (RFS) and overall survival (OS) in young women with BC.
Materials and Methods: This was a retrospective study of women diagnosed with BC at age ≤ 35 years at Allina Health System from 2000 through 2017 (n = 306). Information was collected on germline mutation status, tumor characteristics (grade, hormone receptor, and human epidermal growth factor receptor 2), molecular subtype, pregnancy-associated cancers, and treatment. Survival analyses using Kaplan-Meier curves were conducted for RFS and OS.
Results: With mean follow-up of 6.5 years, OS was 87.0% for invasive cancers, RFS was 84.7%; 69% obtained genetic testing, and 26.9% had HRPVs. There were no differences in RFS or OS between patients with HRPV versus unknown/low/moderate risk variants. Recurrence analysis showed increased recurrence rates in luminal B-like cancers followed by triple negative and human epidermal growth factor receptor 2-positive cancers (P = .041). Pregnancy-associated BC diagnoses, angiolymphatic invasion, and tumor stage were associated with reduced OS. In spite of young age at diagnosis, nearly one-third of patients did not receive germline genetic testing.
Conclusions: Similar survival patterns were found between women with HRPV versus no known mutations. Luminal B-like subtype, pregnancy-associated BC, angiolymphatic invasion, and cancer stage were associated with reduced OS.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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