4.7 Article

Survival from breast cancer in women with a BRCA2 mutation by treatment

Journal

BRITISH JOURNAL OF CANCER
Volume 124, Issue 9, Pages 1524-1532

Publisher

SPRINGERNATURE
DOI: 10.1038/s41416-020-01164-1

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Funding

  1. Cancer Australia [809195, 1100868]
  2. Australian National Breast Cancer Foundation [IF 17, PRAC17-004]
  3. National Health and Medical Research Council [454508, 288704, 145684]
  4. National Institute of Health USA [1RO1CA159868]
  5. Queensland Cancer Fund
  6. Cancer Council of New South Wales
  7. Cancer Council of Victoria
  8. Cancer Council of Tasmania
  9. Cancer Council of South Australia
  10. Cancer Foundation of Western Australia
  11. Peter Gilgan Center for Research on Women's Cancers
  12. Canadian Institute of Health Research [FDN 154275]
  13. NIHR Manchester Biomedical Research Centre [IS-BRC-1215-20007]

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This study aimed to estimate the impact of different treatments on breast cancer-specific survival among patients with a germline BRCA2 mutation. The results indicated that bilateral oophorectomy was associated with a reduced risk of death from breast cancer.
BACKGROUND: The impact of various breast-cancer treatments on patients with a BRCA2 mutation has not been studied. We sought to estimate the impact of bilateral oophorectomy and other treatments on breast cancer-specific survival among patients with a germline BRCA2 mutation. METHODS: We identified 664 women with stage I-III breast cancer and a BRCA2 mutation by combining five different datasets (retrospective and prospective). Subjects were followed for 7.2 years from diagnosis to death from breast cancer. Tumour characteristics and cancer treatments were patient-reported and derived from medical records. Predictors of survival were determined using Cox proportional hazard models, adjusted for other treatments and for prognostic features. RESULTS: The 10-year breast-cancer survival for ER-positive patients was 78.9% and for ER-negative patients was 82.3% (adjusted HR = 1.23 (95% CI, 0.62-2.45, p = 0.55)). The 10-year breast-cancer survival for women who had a bilateral oophorectomy was 89.1% and for women who did not have an oophorectomy was 59.0% (adjusted HR = 0.45; 95% CI, 0.28-0.72, p = 0.001). The adjusted hazard ratio for chemotherapy was 0.83 (95% CI, 0.65-1.53: p = 0.56). CONCLUSIONS: For women with breast cancer and a germline BRCA2 mutation, positive ER status does not predict superior survival. Oophorectomy is associated with a reduced risk of death from breast cancer and should be considered in the treatment plan.

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