Prognosis and clinical presentation of BRCA2-associated breast cancer

54 female breast cancer patients from 22 families with BRCA2 germ line mutations from Sweden and Denmark were compared with 214 age- and date of diagnosis-matched controls identified among breast cancer patients from South Sweden. At diagnosis, BRCA2-associated cases were more often node-positive (N +). OR = 1.9 (95% confidence interval (CI)= 1.0-3.6; P = 0.036), and were more often clinical stage IV: OR = 4.6 (95% CI = 1.3-17; P = 0.021) than the controls. Bilateral disease was also more common among the BRCA2-associated cases: OR = 2.4 (95% CI = 1.1-5.3; P = 0.027). Breast cancer-specific survival (BCSS) was significantly worse among the BRCA2-associated cases: RR = 2.0 (95% CI = 1.2-3.4; P = 0.010). When stage was corrected for in a multivariate analysis, BCSS was no longer significantly worse for the BRCA2-associated cases: RR = 1.6 (95% CI = 0.85-3.1). The corresponding effect after correction for bilateral disease was: RR = 1.8 (95% CI = 1.0-3.1; P = 0.034). The unfavourable prognosis in BRCA2-associated breast cancer seems, to a great extent, to be a consequence of the higher clinical stage at diagnosis. The increased presence of bilateral cancers appears to have less impact on survival in this group of hereditary breast cancer. Data presented here needs to be taken into account when counselling healthy carriers of BRCA2 germ line mutations. (C) 2000 Elsevier Science Ltd. All rights reserved.