Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study.

Autor: van Barele M; Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Rieborn A; Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Heemskerk-Gerritsen BAM; Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Obdeijn IM; Department of Radiology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Koppert LB; Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Loo CE; Department of Radiology, Division of Diagnostic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Tollenaar RAEM; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands., Ausems MGEM; Division Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands., van de Beek I; Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Berger LPV; Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands., de Boer M; Division of Medical Oncology | Department of Internal Medicine, GROW-School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands., van Hest LP; Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands., Kets CM; Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands., Rookus M; Department of Epidemiology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Schmidt MK; Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Jager A; Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands., Hooning MJ; Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands. m.hooning@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2022 Jul; Vol. 194 (1), pp. 159-170. Date of Electronic Publication: 2022 May 04.
DOI: 10.1007/s10549-022-06608-1
Abstrakt: Purpose: Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.
Methods: For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.
Results: 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.
Conclusion: Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.
(© 2022. The Author(s).)
Databáze: MEDLINE
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