Clinical outcomes of female breast cancer according to BRCA mutation status |
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| Institution: | 1. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark;2. Section of Molecular Diagnostics, Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark;3. Department of Clinical Genetics, Odense University Hospital, Odense,Denmark;4. RTI Health Solutions, MA, USA;5. RTI Health Solutions, Barcelona, Spain;6. AstraZeneca, Gaithersburg, MD, USA;7. AbbVie Inc., North Chicago, IL, USA;1. Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA;2. Stanford Cancer Institute, 265 Campus Drive, Suite G2103, Stanford, CA 94305, USA;3. University of Hawaii School of Nursing and Dental Hygiene, 2528 McCarthy Mall, Webster 401, Honolulu, HI 96822, USA;4. University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA;5. University of Southern California, 1450 Biggy Street, Los Angeles, CA 90033, USA;1. Dept. of Gynaecological Oncology, Singleton Hospital, Swansea, United Kingdom;2. Dept. of Oncology, Singleton Hospital, Swansea, United Kingdom;1. Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark;2. University Clinic for Innovative Patient Pathways, Silkeborg Hospital, Department of Clinical Medicine, Aarhus University, Falkevej 1-3, DK-8600 Silkeborg, Denmark;1. Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, China;2. Group of Molecular Epidemiology & Cancer Precision Prevention (GMECPP), Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences (ZJAMS), Hangzhou, China;3. Xiamen Second Hospital, Xiamen, China;4. Jiashan Institute of Cancer Prevention and Treatment, Zhejiang Province, China;1. Department of Otolaryngology-Head and Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, 650-8507, Japan;2. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, 650-8501, Japan |
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| Abstract: | BackgroundTo investigate breast cancer prognosis (disease-free (DFS) and overall survival (OS)) among carriers of germline BRCA mutations (BRCAm) in Denmark.MethodsWe identified all women in Central and Northern Denmark diagnosed with breast cancer during 2004–2011. We retrieved information on germline BRCAm testing from Clinical Genetics departments and clinical/treatment characteristics from population-based medical registries. Follow-up for recurrence, new primary cancer, and mortality extended from 180 days after diagnosis until 31/12/2012. We estimated median DFS and OS and five-year cumulative incidence and incidence rates (IR/1000 person-years), and 95% confidence intervals (95% CI), for each outcome.ResultsAmong 9874 patients, 523 (5%) underwent BRCA testing—90 were BRCAm carriers, 433 were BRCA wildtype (BRCAwt). Compared with BRCAwt women, BRCAm carriers were younger, had lower stage, and ER- and HER2- tumors. Median time from diagnosis to BRCA testing was 0.91 years and 1.3 years in BRCAm and BRCAwt women; median follow-up to first event was 3.9 and 3.4 years, respectively. Five-year DFS and OS were higher in BRCAm than BRCAwt women: 88% (95%CI = 78.3–93.5) vs. 75.3% (95%CI = 70.2–79.6) and 97.8% (95%CI = 91.4–99.4) vs 92.2% (95%CI = 88.5–94.7), respectively. Five-year IRs of recurrence were 36.7/1000 person-years (95%CI = 15.8–72.2) in the BRCAm cohort vs. 58.4 (95%CI = 42.9–77.6) in the BRCAwt cohort.ConclusionsBRCAm carriers may have a better prognosis than BRCAwt women. However, limited testing conducted mainly during follow-up, yielded low numbers for precise estimations, and may be attributable to selection bias. |
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| Keywords: | Breast cancer Breast cancer recurrence Second primary cancer Mortality |
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