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 |
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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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