High risk of in-breast tumor recurrence after BRCA1/2-associated breast cancer
| Autor: | Linda Werner Hartman, Ulf Kristoffersson, Martin Nilsson, Elsa Lanke, Karin M. Henriksson, Oskar Thor Johannsson, Niklas Loman, Åke Borg, Håkan Olsson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Cancer Research Heterozygote Breast-conserving therapy medicine.medical_treatment Breast Neoplasms Mastectomy Segmental Breast tumor Cohort Studies Breast cancer BRCA1/2 Internal medicine Tumor stage medicine Local recurrence Humans Cumulative incidence Mastectomy Genetic testing Hereditary breast cancer Gynecology BRCA2 Protein Sweden medicine.diagnostic_test Radiotherapy business.industry BRCA1 Protein Hazard ratio Middle Aged medicine.disease Clinical Trial Radiation therapy Survival Rate Cancer and Oncology Mutation Female business |
| Zdroj: | Breast Cancer Research and Treatment Breast Cancer Research and Treatment; 147(3), pp 571-578 (2014) |
| ISSN: | 1573-7217 0167-6806 |
| Popis: | The purpose of the study was to compare breast-conserving therapy (BCT) and mastectomy (M) in BRCA1/2 mutation carriers. Women with invasive breast cancer and a pathogenic mutation in BRCA1 or BRCA2 were included in the study (n = 162). Patients treated with BCT (n = 45) were compared with patients treated with M (n = 118). Endpoints were local recurrence as first recurrence (LR), overall survival (OS), breast cancer death, and distant recurrence. Cumulative incidence was calculated in the presence of competing risks. For calculation of hazard ratios and for multivariable analysis, cause-specific Cox proportional hazards regression was used. Compared to M, BCT was associated with an increased risk of LR in univariable analysis (HR 4.0; 95 % CI 1.6-9.8) and in multivariable analysis adjusting for tumor stage, age, and use of adjuvant chemotherapy (HR 2.9; CI 1.1-7.8). Following M, all local recurrences were seen in the first 5 years after breast cancer diagnosis. Following BCT, the rate of LR continued to be high also after the first 5 years. The cumulative incidence of LR in the BCT group was 15, 25, and 32 % after 5, 10, and 15 years, respectively. There were no significant differences between BCT and M for OS, breast cancer death, or distant recurrence. BRCA1/2 mutation carriers treated with BCT have a high risk of LR, many of which are new primary breast cancers. This must be thoroughly discussed with the patient and is an example of how rapid treatment-focused genetic testing could influence choice of treatment. |
| Databáze: | OpenAIRE |
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