Journal
BRITISH JOURNAL OF CANCER
Volume 124, Issue 9, Pages 1524-1532Publisher
SPRINGERNATURE
DOI: 10.1038/s41416-020-01164-1
Keywords
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Categories
Funding
- Cancer Australia [809195, 1100868]
- Australian National Breast Cancer Foundation [IF 17, PRAC17-004]
- National Health and Medical Research Council [454508, 288704, 145684]
- National Institute of Health USA [1RO1CA159868]
- Queensland Cancer Fund
- Cancer Council of New South Wales
- Cancer Council of Victoria
- Cancer Council of Tasmania
- Cancer Council of South Australia
- Cancer Foundation of Western Australia
- Peter Gilgan Center for Research on Women's Cancers
- Canadian Institute of Health Research [FDN 154275]
- 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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