Survival after bilateral risk-reducing mastectomy in healthy BRCA1 and BRCA2 mutation carriers

Autor: A Inge-Marie Obdeijn, Matti A. Rookus, Jakob de Vries, Hester S. A. Oldenburg, Bernadette A M Heemskerk-Gerritsen, Linetta B. Koppert, C. Marleen Kets, Margriet Collée, Agnes Jager, Maartje J. Hooning, Peter Devilee, Marinus J. Blok, Caroline Seynaeve, Klaartje van Engelen, Denise J Jenner, Margreet G. E. M. Ausems, Hanne Meijers-Heijboer, Christi J. van Asperen
Přispěvatelé: Academic Medical Center, ARD - Amsterdam Reproduction and Development, MUMC+: DA KG Lab Centraal Lab (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, CCA - Cancer Treatment and quality of life, Amsterdam Neuroscience - Complex Trait Genetics, Human genetics, Pediatric surgery, Amsterdam Reproduction & Development (AR&D), Medical Oncology, Surgery, Radiology & Nuclear Medicine, Clinical Genetics
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Cancer Research
Survival
Epidemiology
SURGERY
medicine.medical_treatment
FAMILIES
0302 clinical medicine
Public Health Surveillance
CONTRALATERAL BREAST-CANCER
skin and connective tissue diseases
Mastectomy
Netherlands
Surveillance
BRCA1 Protein
Mortality rate
Hazard ratio
PROPHYLACTIC MASTECTOMY
WOMEN
Prognosis
SERIES
3. Good health
TIME
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Oncology
030220 oncology & carcinogenesis
Bilateral risk-reducing mastectomy
Mutation (genetic algorithm)
Female
Cohort study
medicine.medical_specialty
Heterozygote
STRATEGIES
Breast Neoplasms
OVARIAN-CANCER
03 medical and health sciences
Breast cancer
All institutes and research themes of the Radboud University Medical Center
BRCA1/2
Internal medicine
medicine
Humans
Mortality
Germ-Line Mutation
BRCA2 Protein
Proportional hazards model
business.industry
Prevention
BRCA mutation
medicine.disease
BRCA1
EFFICACY
030104 developmental biology
Mutation
business
Risk Reduction Behavior
Zdroj: Breast Cancer Research and Treatment, 177(3), 723-733. SPRINGER
Breast Cancer Research and Treatment, 177, 3, pp. 723-733
Breast Cancer Research and Treatment, 177, 723-733
Breast cancer research and treatment, 177(3), 723-733. Springer New York
Breast Cancer Research and Treatment, 177(3), 723-733. Springer, Cham
Breast Cancer Research and Treatment, 177(3), 723-733. Springer New York
Breast Cancer Research and Treatment
Heemskerk-Gerritsen, B A M, Jager, A, Koppert, L B, Obdeijn, A I-M, Collée, M, Meijers-Heijboer, H E J, Jenner, D J, Oldenburg, H S A, van Engelen, K, de Vries, J, van Asperen, C J, Devilee, P, Blok, M J, Kets, C M, Ausems, M G E M, Seynaeve, C, Rookus, M A & Hooning, M J 2019, ' Survival after bilateral risk-reducing mastectomy in healthy BRCA1 and BRCA2 mutation carriers ', Breast Cancer Research and Treatment, vol. 177, no. 3, pp. 723-733 . https://doi.org/10.1007/s10549-019-05345-2
ISSN: 0167-6806
Popis: Background In healthy BRCA1/2 mutation carriers, bilateral risk-reducing mastectomy (BRRM) strongly reduces the risk of developing breast cancer (BC); however, no clear survival benefit of BRRM over BC surveillance has been reported yet. Methods In this Dutch multicenter cohort study, we used multivariable Cox models with BRRM as a time-dependent covariable to estimate the associations between BRRM and the overall and BC-specific mortality rates, separately for BRCA1 and BRCA2 mutation carriers. Results During a mean follow-up of 10.3 years, 722 out of 1712 BRCA1 (42%) and 406 out of 1145 BRCA2 (35%) mutation carriers underwent BRRM. For BRCA1 mutation carriers, we observed 52 deaths (20 from BC) in the surveillance group, and 10 deaths (one from BC) after BRRM. The hazard ratios were 0.40 (95% CI 0.20–0.90) for overall mortality and 0.06 (95% CI 0.01–0.46) for BC-specific mortality. BC-specific survival at age 65 was 93% for surveillance and 99.7% for BRRM. For BRCA2 mutation carriers, we observed 29 deaths (7 from BC) in the surveillance group, and 4 deaths (no BC) after BRRM. The hazard ratio for overall mortality was 0.45 (95% CI 0.15–1.36). BC-specific survival at age 65 was 98% for surveillance and 100% for BRRM. Conclusion BRRM was associated with lower mortality than surveillance for BRCA1 mutation carriers, but for BRCA2 mutation carriers, BRRM may lead to similar BC-specific survival as surveillance. Our findings support a more individualized counseling based on BRCA mutation type. Electronic supplementary material The online version of this article (10.1007/s10549-019-05345-2) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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