期刊
JOURNAL OF CLINICAL ONCOLOGY
卷 22, 期 12, 页码 2328-2335出版社
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JCO.2004.04.033
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Purpose To estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers after diagnosis and to determine which factors are predictive of the risk of a second primary breast cancer. Patients and Methods Patients included 491 women with stage I or stage 11 breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up. Results The actuarial risk of contralateral breast cancer was 29.5% at 10 years. Factors that were predictive of a reduced risk were the presence of a BRCA2 mutation (v BRCA1 mutation; hazard ratio [HR], 0.73; 95% Cl, 0.47 to 1.15), age 50 years or older at first diagnosis (v : 49 years; HR, 0.63 95% Cl, 0.36 to 1.10), use of tannoxifen (HR, 0.59; 95% Cl, 0.35 to 1.01); and history of cophorectomy (HR, 0.44; 95% Cl, 0.21 to 0.91). The effect of cophorectomy was particularly strong in women first diagnosed prior to age 49 years (HR, 0.24, 95% Cl, 0.07 to 0.77). For women who did not have an oophorectomy or take tamoxifen, the 10-year risk of contralateral cancer was 43.4% for BRCA1 carriers and 34.6% for BRCA2 carriers. Conclusion The risk of contralateral breast cancer in women with a BRCA mutation is approximately 40% at 10 years, and is reduced in women who take tamoxifen or who undergo an oophorectomy. (C) 2004 by American Society of Clinical Oncology.
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