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- Title
Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers.
- Authors
Metcalfe, K; Gershman, S; Lynch, H T; Ghadirian, P; Tung, N; Kim-Sing, C; Olopade, O I; Domchek, S; McLennan, J; Eisen, A; Foulkes, W D; Rosen, B; Sun, P; Narod, S A
- Abstract
<bold>Purpose: </bold>The objective of this study was to estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers; and measure the extent to which host, family history, and cancer treatment-related factors modify the risk.<bold>Patients and Methods: </bold>Patients were 810 women, with stage I or II 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.<bold>Results: </bold>Overall, 149 subjects (18.4%) developed a contralateral breast cancer. The 15-year actuarial risk of contralateral breast cancer was 36.1% for women with a BRCA1 mutation and was 28.5% for women with a BRCA2 mutation. Women younger than 50 years of age at the time of breast cancer diagnosis were significantly more likely to develop a contralateral breast cancer at 15 years, compared with those older than 50 years (37.6 vs 16.8%; P=0.003). Women aged <50 years with two or more first-degree relatives with early-onset breast cancer were at high risk of contralateral breast cancer, compared with women with fewer, or no first-degree relatives with breast cancer (50 vs 36%; P=0.005). The risk of contralateral breast cancer was reduced with oophorectomy (RR 0.47; 95% CI 0.30-0.76; P=0.002).<bold>Conclusion: </bold>The risk of contralateral breast cancer risk in BRCA mutation carriers declines with the age of diagnosis and increases with the number of first-degree relatives affected with breast cancer. Oophorectomy reduces the risk of contralateral breast cancer in young women with a BRCA mutation.
- Subjects
NORTH America; BREAST cancer; CANCER patients; TAMOXIFEN; RADIOTHERAPY; BREAST tumor diagnosis; BREAST tumor treatment; AGE distribution; BREAST tumors; COMPARATIVE studies; DISEASE susceptibility; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; GENETIC mutation; OVARIECTOMY; RESEARCH; RISK assessment; SURVIVAL analysis (Biometry); EVALUATION research; BRCA genes; PREDICTIVE tests; GENETIC carriers; ODDS ratio; SECONDARY primary cancer; PREVENTION; DIAGNOSIS
- Publication
British Journal of Cancer, 2011, Vol 104, Issue 9, p1384
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/bjc.2011.120