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 |
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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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