BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials

Madeleine M. A. Tilanus-Linthorst, Inge-Marie Obdeijin, Wim C. J. Hop, Petrina A. Causer, Martin O. Leach, Ellen Warner, Linda Pointon, Kimberley Hill, Jan G. M. Klijn, Ruth M. L. Warren, Fiona Jane Gilbert

Research output: Contribution to journalArticle

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Abstract

Purpose: Magnetic resonance imaging (MRI) screening enables early detection of breast cancers in women with an inherited predisposition. Interval cancers occurred in women with a BRCA1 mutation, possibly due to fast tumor growth. We investigated the effect of a BRCA1 or BRCA2 mutation and age on the growth rate of breast cancers, as this may influence the optimal screening frequency.

Experimental Design: We reviewed the invasive cancers from the United Kingdom, Dutch, and Canadian MRI screening trials for women at hereditary risk, measuring tumor size at diagnosis and on preceding MRI and/or mammography. We could assess tumor volume doubling time (DT) in 100 cancers.

Results: Tumor DT was estimated for 43 women with a BRCA1 mutation, 16 women with a BRCA2 mutation, and 41 women at high risk without an identified mutation. Growth rate slowed continuously with increasing age (P = 0.004). Growth was twice as fast in BRCA1 (P = 0.003) or BRCA2 (P = 0.03) patients as in high-risk patients of the same age. The mean DT for women with BRCA1/2 mutations diagnosed at ages : 40, 41 to 50, and > 50 years was 28, 68, and 81 days, respectively, and 83, 121, and 173 days, respectively, in the high-risk group. Pathologic tumor size decreased with increasing age (P = 0.001). Median size was 15 mm for patients ages <= 40 years compared with 9 mm in older patients (P = 0.003); tumors were largest in young women with BRCA1 mutations.

Conclusion: Tumors grow quickly in women with BRCA1 mutations and in young women. Age and risk group should be taken into account in screening protocols.

Original languageEnglish
Pages (from-to)7357-7362
Number of pages6
JournalClinical Cancer Research
Volume13
DOIs
Publication statusPublished - 15 Dec 2007

Keywords

  • high familial risk
  • mammographic density
  • prognostic-factors
  • natural-history
  • survival
  • carriers
  • women
  • surveillance
  • ultrasound
  • maribs

Cite this

Tilanus-Linthorst, M. M. A., Obdeijin, I-M., Hop, W. C. J., Causer, P. A., Leach, M. O., Warner, E., ... Gilbert, F. J. (2007). BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials. Clinical Cancer Research, 13, 7357-7362. https://doi.org/10.1158/1078-0432.CCR-07-0689

BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials. / Tilanus-Linthorst, Madeleine M. A.; Obdeijin, Inge-Marie; Hop, Wim C. J.; Causer, Petrina A.; Leach, Martin O.; Warner, Ellen; Pointon, Linda; Hill, Kimberley; Klijn, Jan G. M.; Warren, Ruth M. L.; Gilbert, Fiona Jane.

In: Clinical Cancer Research, Vol. 13, 15.12.2007, p. 7357-7362.

Research output: Contribution to journalArticle

Tilanus-Linthorst, MMA, Obdeijin, I-M, Hop, WCJ, Causer, PA, Leach, MO, Warner, E, Pointon, L, Hill, K, Klijn, JGM, Warren, RML & Gilbert, FJ 2007, 'BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials', Clinical Cancer Research, vol. 13, pp. 7357-7362. https://doi.org/10.1158/1078-0432.CCR-07-0689
Tilanus-Linthorst, Madeleine M. A. ; Obdeijin, Inge-Marie ; Hop, Wim C. J. ; Causer, Petrina A. ; Leach, Martin O. ; Warner, Ellen ; Pointon, Linda ; Hill, Kimberley ; Klijn, Jan G. M. ; Warren, Ruth M. L. ; Gilbert, Fiona Jane. / BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials. In: Clinical Cancer Research. 2007 ; Vol. 13. pp. 7357-7362.
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abstract = "Purpose: Magnetic resonance imaging (MRI) screening enables early detection of breast cancers in women with an inherited predisposition. Interval cancers occurred in women with a BRCA1 mutation, possibly due to fast tumor growth. We investigated the effect of a BRCA1 or BRCA2 mutation and age on the growth rate of breast cancers, as this may influence the optimal screening frequency.Experimental Design: We reviewed the invasive cancers from the United Kingdom, Dutch, and Canadian MRI screening trials for women at hereditary risk, measuring tumor size at diagnosis and on preceding MRI and/or mammography. We could assess tumor volume doubling time (DT) in 100 cancers.Results: Tumor DT was estimated for 43 women with a BRCA1 mutation, 16 women with a BRCA2 mutation, and 41 women at high risk without an identified mutation. Growth rate slowed continuously with increasing age (P = 0.004). Growth was twice as fast in BRCA1 (P = 0.003) or BRCA2 (P = 0.03) patients as in high-risk patients of the same age. The mean DT for women with BRCA1/2 mutations diagnosed at ages : 40, 41 to 50, and > 50 years was 28, 68, and 81 days, respectively, and 83, 121, and 173 days, respectively, in the high-risk group. Pathologic tumor size decreased with increasing age (P = 0.001). Median size was 15 mm for patients ages <= 40 years compared with 9 mm in older patients (P = 0.003); tumors were largest in young women with BRCA1 mutations.Conclusion: Tumors grow quickly in women with BRCA1 mutations and in young women. Age and risk group should be taken into account in screening protocols.",
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author = "Tilanus-Linthorst, {Madeleine M. A.} and Inge-Marie Obdeijin and Hop, {Wim C. J.} and Causer, {Petrina A.} and Leach, {Martin O.} and Ellen Warner and Linda Pointon and Kimberley Hill and Klijn, {Jan G. M.} and Warren, {Ruth M. L.} and Gilbert, {Fiona Jane}",
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T1 - BRCA1 Mutation and Young Age Predict Fast Breast Cancer Growth in the Dutch, United Kingdom, and Canadian Magnetic Resonance Imaging Screening Trials

AU - Tilanus-Linthorst, Madeleine M. A.

AU - Obdeijin, Inge-Marie

AU - Hop, Wim C. J.

AU - Causer, Petrina A.

AU - Leach, Martin O.

AU - Warner, Ellen

AU - Pointon, Linda

AU - Hill, Kimberley

AU - Klijn, Jan G. M.

AU - Warren, Ruth M. L.

AU - Gilbert, Fiona Jane

PY - 2007/12/15

Y1 - 2007/12/15

N2 - Purpose: Magnetic resonance imaging (MRI) screening enables early detection of breast cancers in women with an inherited predisposition. Interval cancers occurred in women with a BRCA1 mutation, possibly due to fast tumor growth. We investigated the effect of a BRCA1 or BRCA2 mutation and age on the growth rate of breast cancers, as this may influence the optimal screening frequency.Experimental Design: We reviewed the invasive cancers from the United Kingdom, Dutch, and Canadian MRI screening trials for women at hereditary risk, measuring tumor size at diagnosis and on preceding MRI and/or mammography. We could assess tumor volume doubling time (DT) in 100 cancers.Results: Tumor DT was estimated for 43 women with a BRCA1 mutation, 16 women with a BRCA2 mutation, and 41 women at high risk without an identified mutation. Growth rate slowed continuously with increasing age (P = 0.004). Growth was twice as fast in BRCA1 (P = 0.003) or BRCA2 (P = 0.03) patients as in high-risk patients of the same age. The mean DT for women with BRCA1/2 mutations diagnosed at ages : 40, 41 to 50, and > 50 years was 28, 68, and 81 days, respectively, and 83, 121, and 173 days, respectively, in the high-risk group. Pathologic tumor size decreased with increasing age (P = 0.001). Median size was 15 mm for patients ages <= 40 years compared with 9 mm in older patients (P = 0.003); tumors were largest in young women with BRCA1 mutations.Conclusion: Tumors grow quickly in women with BRCA1 mutations and in young women. Age and risk group should be taken into account in screening protocols.

AB - Purpose: Magnetic resonance imaging (MRI) screening enables early detection of breast cancers in women with an inherited predisposition. Interval cancers occurred in women with a BRCA1 mutation, possibly due to fast tumor growth. We investigated the effect of a BRCA1 or BRCA2 mutation and age on the growth rate of breast cancers, as this may influence the optimal screening frequency.Experimental Design: We reviewed the invasive cancers from the United Kingdom, Dutch, and Canadian MRI screening trials for women at hereditary risk, measuring tumor size at diagnosis and on preceding MRI and/or mammography. We could assess tumor volume doubling time (DT) in 100 cancers.Results: Tumor DT was estimated for 43 women with a BRCA1 mutation, 16 women with a BRCA2 mutation, and 41 women at high risk without an identified mutation. Growth rate slowed continuously with increasing age (P = 0.004). Growth was twice as fast in BRCA1 (P = 0.003) or BRCA2 (P = 0.03) patients as in high-risk patients of the same age. The mean DT for women with BRCA1/2 mutations diagnosed at ages : 40, 41 to 50, and > 50 years was 28, 68, and 81 days, respectively, and 83, 121, and 173 days, respectively, in the high-risk group. Pathologic tumor size decreased with increasing age (P = 0.001). Median size was 15 mm for patients ages <= 40 years compared with 9 mm in older patients (P = 0.003); tumors were largest in young women with BRCA1 mutations.Conclusion: Tumors grow quickly in women with BRCA1 mutations and in young women. Age and risk group should be taken into account in screening protocols.

KW - high familial risk

KW - mammographic density

KW - prognostic-factors

KW - natural-history

KW - survival

KW - carriers

KW - women

KW - surveillance

KW - ultrasound

KW - maribs

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DO - 10.1158/1078-0432.CCR-07-0689

M3 - Article

VL - 13

SP - 7357

EP - 7362

JO - Clinical Cancer Research

JF - Clinical Cancer Research

SN - 1078-0432

ER -