Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy

P. Moller, A. Borg, D. G. Evans, Neva Elizabeth Haites, M. M. Reis, H. Vasen, Eileen Anderson, C. M. Steel, J. Apold, D. Goudie, A. Howell, F. Lalloo, L. Maehle

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Abstract

Dedicated clinics have been established for the early diagnosis and treatment of women at risk for inherited breast cancer, but the effects of such interventions are currently unproven. This second report on prospectively diagnosed inherited breast cancer from the European collaborating centres supports the previous conclusions and adds information on genetic heterogeneity and the effect of oophorectomy. Of 249 patients, 20% had carcinoma in situ (CIS), 54% had infiltrating cancer without spread (CaNO) and 26% had cancer with spread (CaN+). Five-year survival was 100% for CIS, 94% for CaNO and 72% for CaN+ (p = 0.007). Thirty-six patients had BRCA1 mutations, and 8 had BRCA2 mutations. Presence of BRCA1 mutation was associated with infiltrating cancer, high grade and lack of oestrogen receptor (p < 0.05 for all 3 characteristics). For BRCA1 mutation carriers, 5-year survival was 63% vs. 91% for noncarriers (p = 0.04). For CaNO patients, mutation carriers had 75% S-year disease-free survival vs. 96% for noncarriers (p = 0.01). Twenty-one of the mutation carriers had undergone prophylactic oophorectomy, prior to or within 6 months of diagnosis in 13 cases. All but I relapse occurred in the I S who had kept their ovaries, (p < 0.01); no relapse occurred in those who had removed the ovaries within 6 months (p = 0.04) Contralateral cancer was more frequently observed in mutation noncarriers, but this finding did not reach statistical significance. Our findings support the concept that BRCA1 cancer is biologically different from other inherited breast cancers. While current screening protocols appear satisfactory for the majority of women at risk of familial breast cancer, this may not be the case for BRCA1 mutation carriers. The observed effect of oophorectomy was striking. (C) 2002 Wiley-Liss, Inc.

Original languageEnglish
Pages (from-to)555-559
Number of pages4
JournalInternational Journal of Cancer
Volume101
Issue number6
DOIs
Publication statusPublished - 2002

Keywords

  • breast cancer
  • BRCA1
  • oophorectomy
  • prognosis
  • survival
  • PROPHYLACTIC MASTECTOMY
  • INHERITED BREAST
  • OVARIAN-CANCER
  • WOMEN
  • RISK
  • CARRIERS
  • EFFICACY
  • HISTORY
  • DIAGNOSIS
  • AGE

Cite this

Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy. / Moller, P.; Borg, A.; Evans, D. G.; Haites, Neva Elizabeth; Reis, M. M.; Vasen, H.; Anderson, Eileen; Steel, C. M.; Apold, J.; Goudie, D.; Howell, A.; Lalloo, F.; Maehle, L.

In: International Journal of Cancer, Vol. 101, No. 6, 2002, p. 555-559.

Research output: Contribution to journalArticle

Moller, P, Borg, A, Evans, DG, Haites, NE, Reis, MM, Vasen, H, Anderson, E, Steel, CM, Apold, J, Goudie, D, Howell, A, Lalloo, F & Maehle, L 2002, 'Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy', International Journal of Cancer, vol. 101, no. 6, pp. 555-559. https://doi.org/10.1002/ijc.10641
Moller, P. ; Borg, A. ; Evans, D. G. ; Haites, Neva Elizabeth ; Reis, M. M. ; Vasen, H. ; Anderson, Eileen ; Steel, C. M. ; Apold, J. ; Goudie, D. ; Howell, A. ; Lalloo, F. ; Maehle, L. / Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy. In: International Journal of Cancer. 2002 ; Vol. 101, No. 6. pp. 555-559.
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AU - Borg, A.

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AU - Haites, Neva Elizabeth

AU - Reis, M. M.

AU - Vasen, H.

AU - Anderson, Eileen

AU - Steel, C. M.

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AU - Goudie, D.

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AU - Lalloo, F.

AU - Maehle, L.

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AB - Dedicated clinics have been established for the early diagnosis and treatment of women at risk for inherited breast cancer, but the effects of such interventions are currently unproven. This second report on prospectively diagnosed inherited breast cancer from the European collaborating centres supports the previous conclusions and adds information on genetic heterogeneity and the effect of oophorectomy. Of 249 patients, 20% had carcinoma in situ (CIS), 54% had infiltrating cancer without spread (CaNO) and 26% had cancer with spread (CaN+). Five-year survival was 100% for CIS, 94% for CaNO and 72% for CaN+ (p = 0.007). Thirty-six patients had BRCA1 mutations, and 8 had BRCA2 mutations. Presence of BRCA1 mutation was associated with infiltrating cancer, high grade and lack of oestrogen receptor (p < 0.05 for all 3 characteristics). For BRCA1 mutation carriers, 5-year survival was 63% vs. 91% for noncarriers (p = 0.04). For CaNO patients, mutation carriers had 75% S-year disease-free survival vs. 96% for noncarriers (p = 0.01). Twenty-one of the mutation carriers had undergone prophylactic oophorectomy, prior to or within 6 months of diagnosis in 13 cases. All but I relapse occurred in the I S who had kept their ovaries, (p < 0.01); no relapse occurred in those who had removed the ovaries within 6 months (p = 0.04) Contralateral cancer was more frequently observed in mutation noncarriers, but this finding did not reach statistical significance. Our findings support the concept that BRCA1 cancer is biologically different from other inherited breast cancers. While current screening protocols appear satisfactory for the majority of women at risk of familial breast cancer, this may not be the case for BRCA1 mutation carriers. The observed effect of oophorectomy was striking. (C) 2002 Wiley-Liss, Inc.

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KW - oophorectomy

KW - prognosis

KW - survival

KW - PROPHYLACTIC MASTECTOMY

KW - INHERITED BREAST

KW - OVARIAN-CANCER

KW - WOMEN

KW - RISK

KW - CARRIERS

KW - EFFICACY

KW - HISTORY

KW - DIAGNOSIS

KW - AGE

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JF - International Journal of Cancer

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