Effects of chemotherapy on contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers

Autor: Akdeniz, D., Barele, M. van, Heemskerk-Gerritsen, B.A.M., Steyerberg, E.W., Hauptmann, M., Beek, I. van de, Engelen, K. van, Wevers, M.R., Garcia, E.B.G., Ausems, M.G.E.M., Berger, L.P.V., Asperen, C.J. van, Adank, M.A., Collee, M.J., Stommel-Jenner, D.J., Jager, A., Schmidt, M.K., Hooning, M.J., HEBON Investigators
Přispěvatelé: Medical Oncology, Public Health, Clinical Genetics, Faculteit Medische Wetenschappen/UMCG, Clinical genetics, Epidemiology and Data Science, RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: DA KG Polikliniek (9), Klinische Genetica
Jazyk: angličtina
Rok vydání: 2022
Předmět:
PALGA
The nationwide network and registry of histo- and cytopathology in The Netherlands
Heterozygote
Secondary
endocrine system diseases
Breast Neoplasms
MUTATION CARRIERS
HEBON
Hereditary Breast and Ovarian cancer research Netherlands
Cohort Studies
NEOADJUVANT CHEMOTHERAPY
All institutes and research themes of the Radboud University Medical Center
Breast cancer
PROGNOSTIC-FACTORS
SDG 3 - Good Health and Well-being
Humans
Chemotherapy
Genetic Predisposition to Disease
skin and connective tissue diseases
RC254-282
BRCA2 Protein
PBC
primary breast cancer
BRCA1 Protein
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
General Medicine
BRCA1
HR
hazard ratio
BRCA2
CI
confidence interval
GRADE
Risk factors
Chemotherapy
Adjuvant
Mutation
SURVIVAL
Surgery
Original Article
CBC
contralateral breast cancer
Female
CMF
cyclophosphamide
methotrexate
5-fluorouracil
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
NCR
Netherlands Cancer Registry
Zdroj: HEBON Investigators 2021, ' Effects of chemotherapy on contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers : A nationwide cohort study ', Breast, vol. 61, pp. 98-107 . https://doi.org/10.1016/j.breast.2021.12.007
The Breast : Official Journal of the European Society of Mastology
Breast, 61, 98-107. Churchill Livingstone
Breast, 61, 98-107
The Breast, 61, 98-107. CHURCHILL LIVINGSTONE
Breast, Vol 61, Iss, Pp 98-107 (2022)
Breast, 61, pp. 98-107
ISSN: 1532-3080
0960-9776
Popis: Aim BRCA1/2 mutation carriers with primary breast cancer (PBC) are at high risk of contralateral breast cancer (CBC). In a nationwide cohort, we investigated the effects of chemotherapeutic agents given for PBC on CBC risk separately in BRCA1 and BRCA2 mutation carriers. Patients and methods BRCA1 or BRCA2 mutation carriers with an invasive PBC diagnosis from 1990 to 2017 were selected from a Dutch cohort. We estimated cumulative CBC incidence using competing risks analysis. Hazard ratios (HR) for the effect of neo-adjuvant or adjuvant chemotherapy and different chemotherapeutic agents on CBC risk were estimated using Cox regression. Results We included 1090 BRCA1 and 568 BRCA2 mutation carriers; median follow-up was 8.9 and 8.4 years, respectively. Ten-year cumulative CBC incidence for treatment with and without chemotherapy was 6.7% [95%CI: 5.1–8.6] and 16.7% [95%CI: 10.8–23.7] in BRCA1 and 4.8% [95%CI: 2.7–7.8] and 16.0% [95%CI: 9.3–24.4] in BRCA2 mutation carriers, respectively. Chemotherapy was associated with reduced CBC risk in BRCA1 (multivariable HR: 0.46, 95%CI: 0.29–0.74); a similar trend was observed in BRCA2 mutation carriers (HR: 0.63, 95%CI: 0.29–1.39). In BRCA1, risk reduction was most pronounced in the first 5 years (HR: 0.32, 95%CI: 0.17–0.61). Anthracyclines and the combination of anthracyclines with taxanes were associated with substantial CBC risk reduction in BRCA1 carriers (HR: 0.34, 95%CI: 0.17–0.68 and HR: 0.22, 95%CI: 0.08–0.62, respectively). Conclusion Risk-reducing effects of chemotherapy are substantial for at least 5 years and may be used in personalised CBC risk prediction in any case for BRCA1 mutation carriers.
Highlights • Contralateral breast cancer (CBC) risk is high in BRCA1/2 mutation carriers. • Chemotherapy for primary breast cancer results in decreased CBC risk in BRCA1. • Anthracyclines with/without taxanes show the largest CBC risk reduction in BRCA1. • For BRCA2 similar trends are observed as in BRCA1 mutation carriers. • Chemotherapy must be considered in personalised CBC risk models.
Databáze: OpenAIRE
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