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01-04-2018 | Epidemiology

Predictors of survival for breast cancer patients with a BRCA1 mutation

Authors: Steven A. Narod, Tomasz Huzarski, Jacek Gronwald, Tomasz Byrski, Elzbieta Marczyk, Cezary Cybulski, Marek Szwiec, Rafal Wisniowski, Bozena Birkenfeld, Ewa Kilar, Robert Sibilski, Ping Sun, Jan Lubinski

Published in: Breast Cancer Research and Treatment | Issue 2/2018

Abstract

Purpose

To evaluate in a contemporary cohort the impacts of chemotherapy and oophorectomy on survival for breast cancer patients with a BRCA1 mutation.

Experimental design

We reviewed the pathology reports and medical records of 372 women with breast cancer and a BRCA1 mutation, diagnosed from 2005 to 2017, between the ages of 25 and 65 and followed them for death from all causes and death from breast cancer. Death was ascertained through the Poland vital statistics registry. We performed survival analysis to evaluate the impacts of chemotherapy (including neoadjuvant cisplatinum) and of oophorectomy on survival.

Results

After a mean follow-up of 5.6 years (median 5.2), 66 of the 372 women died; 56 of the deaths were from breast cancer and 6 were from ovarian cancer. 127 women received neoadjuvant cisplatinum and 245 women received other chemotherapies. Cisplatinum (versus all other therapies) was associated with a hazard ratio of 0.42 (95%CI 0.20–0.87) on breast cancer-specific survival. The 10-year actuarial all-cause survival for women who had both cisplatinum and an oophorectomy was 94.4%. The 10-year all-cause survival for women who had neither cisplatinum nor an oophorectomy was 65.4% (p < 0.01).

Conclusions

Cisplatinum and oophorectomy are effective therapies for women with breast cancer and a BRCA1 mutation.

Jonasson JG, Stefansson OA, Johannsson OT, Sigurdsson H, Agnarsson BA, Olafsdottir GH, Alexiusdottir KK, Stefansdottir H, Munoz Mitev R, Olafsdottir K, Olafsdottir K, Arason A, Stefansdottir V, Olafsdottir EJ, Barkardottir RB, Eyfjord JE, Narod SA, Tryggvadóttir L (2016) Oestrogen receptor status, treatment and breast cancer prognosis in Icelandic BRCA2 mutation carriers. Br J Cancer 115(7):776–783CrossRefPubMedPubMedCentral

Cybulski C, Kluźniak W, Huzarski T, Wokołorczyk D, Kashyap A, Jakubowska A, Szwiec M, Byrski T, Dębniak T, Górski B, Sopik V, Akbari MR, Sun P, Gronwald J, Narod SA (2015) Lubiński J; Polish Hereditary Breast Cancer Consortium. Clinical outcomes in women with breast cancer and a PALB2 mutation: a prospective cohort analysis. Lancet Oncol 16(6):638–644CrossRefPubMed

Marcus JN, Watson P, Page DL, Narod SA, Tonin P, Lenoir GM, Serova O, Lynch HT (1997) BRCA2 hereditary breast cancer pathophenotype. Breast Cancer Res Treat 44:275–277CrossRefPubMed

Lakhani SR, Jacquemier J, Sloane JP, Gusterson BA, Anderson TJ, van de Vijver MJ, Farid LM, Venter D, Antoniou A, Storger-Isser A, Smyth E, Steel CM, Haites N, Scott RJ, Goldgar D, Neuhausen S, Daly PA, Ormiston W, McManus R, Scherneck S, Ponder BA, Ford D, Peto J, Stoppa-Lyonnet D, Bignon YJ, Struewing JP, Spurr NK, Bishop DT, Klijn JG, Devilee P et al (1998) Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst 90:1138–1145CrossRefPubMed

Narod SA, Metcalfe K, Lynch HT, Ghadirian P, Robidoux A, Tung N, Gaughan E, Kim-Sing C, Olopade OI, Foulkes WD, Robson M, Offit K, Jakubowska A, Byrski T, Huzarski T, Sun P, Lubinski J (2013) Should all BRCA1 mutation carriers with stage I breast cancer receive chemotherapy? Breast Cancer Res Treat 138(1):273–279CrossRefPubMed

Byrski T, Huzarski T, Dent R, Marczyk E, Jasiowka M, Gronwald J, Jakubowicz J, Cybulski C, Wisniowski R, Godlewski D, Lubinski J, Narod SA (2014) Pathologic complete response to neoadjuvant cisplatin in BRCA1-positive breast cancer patients. Breast Cancer Res Treat 147(2):401–405CrossRefPubMed

Arun B, Bayraktar S, Liu DD, Gutierrez Barrera AM, Atchley D, Pusztai L, Litton JK, Valero V, Meric-Bernstam F, Hortobagyi GN, Albarracin C (2011) Response to neoadjuvant systemic therapy for breast cancer in BRCA mutation carriers and noncarriers: a single-institution experience. J Clin Oncol 29(28):3739–3746CrossRefPubMedPubMedCentral

Finch AP, Lubinski J, Møller P, Singer CF, Karlan B, Senter L, Rosen B, Maehle L, Ghadirian P, Cybulski C, Huzarski T, Eisen A, Foulkes WD, Kim-Sing C, Ainsworth P, Tung N, Lynch HT, Neuhausen S, Metcalfe KA, Thompson I, Murphy J, Sun P, Narod SA (2014) Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. J Clin Oncol 32(15):1547–1553CrossRefPubMedPubMedCentral

Metcalfe K, Lynch HT, Foulkes WD, Tung N, Kim-Sing C, Olopade OI, Eisen A, Rosen B, Snyder C, Gershman S, Sun P, Narod SA (2015) Effect of oophorectomy on survival after breast cancer in BRCA1 and BRCA2 mutation carriers. JAMA Oncol. 1(3):306–313CrossRefPubMed

10.

Huzarski T, Byrski T, Gronwald J, Cybulski C, Oszurek O, Szwiec M, Gugała K, Stawicka M, Morawiec Z, Mierzwa T, Falco M, Janiszewska H, Kilar E, Marczyk E, Kozak-Klonowska B, Siołek M, Surdyka D, Wiśniowski R, Posmyk M, Domagała P, Sun P, Lubiński J (2016) Narod SA; Polish Breast Cancer Consortium. The impact of oophorectomy on survival after breast cancer in BRCA1-positive breast cancer patients. Breast Cancer Res Treat 156(2):371–378CrossRefPubMed

11.

Robson M, Im SA, Senkus E, Xu B, Domchek SM, Masuda N, Delaloge S, Li W, Tung N, Armstrong A, Wu W, Goessl C, Runswick S, Conte P (2017) Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation. N Engl J Med 377(6):523–533CrossRefPubMed

12.

Górski B, Byrski T, Huzarski T, Jakubowska A, Menkiszak J, Gronwald J, Pluzanski A, Bebenek M, Fischer-Maliszewska L, Grzybowska E, Narod SA, Lubinski J (2000) Founder mutations in BRCA1 gene in Polish families with breast-ovarian cancer. Am J Hum Genet 66:1963–1968CrossRefPubMedPubMedCentral

13.

Long Roche KC, Abu-Rustum NR, Nourmoussavi M, Zivanovic O (2017) Risk-reducing salpingectomy: let us be opportunistic. Cancer 123(10):1714–1720CrossRefPubMed

14.

Labidi-Galy SI, Papp E, Hallberg D, Niknafs N, Adleff V, Noe M, Bhattacharya R, Novak M, Jones S, Phallen J, Hruban CA, Hirsch MS, Lin DI, Schwartz L, Maire CL, Tille JC, Bowden M, Ayhan A, Wood LD, Scharpf RB, Kurman R, Wang TL, Shih IM, Karchin R, Drapkin R, Velculescu VE (2017) High grade serous ovarian carcinomas originate in the fallopian tube. Nat Commun 8(1):1093CrossRefPubMedPubMedCentral

15.

Heemskerk-Gerritsen BA, Seynaeve C, van Asperen CJ, Ausems MG, Collée JM, van Doorn HC, Gomez Garcia EB, Kets CM, van Leeuwen FE, Meijers-Heijboer HE, Mourits MJ, van Os TA, Vasen HF, Verhoef S, Rookus MA, Hooning MJ; Hereditary Breast and Ovarian Cancer Research Group Netherlands (2015) Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djv033

16.

Kotsopoulos J, Huzarski T, Gronwald J, Singer CF, Moller P, Lynch HT, Armel S, Karlan B, Foulkes WD, Neuhausen SL, Senter L, Tung N, Weitzel JN, Eisen A, Metcalfe K, Eng C, Pal T, Evans G, Sun P, Lubinski J, Narod SA, Hereditary Breast Cancer Clinical Study Group (2016) Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 Mutation Carriers. J Natl Cancer. https://doi.org/10.1093/jnci/djw177

Title: Predictors of survival for breast cancer patients with a BRCA1 mutation
Authors: Steven A. Narod
Tomasz Huzarski
Jacek Gronwald
Tomasz Byrski
Elzbieta Marczyk
Cezary Cybulski
Marek Szwiec
Rafal Wisniowski
Bozena Birkenfeld
Ewa Kilar
Robert Sibilski
Ping Sun
Jan Lubinski
Publication date: 01-04-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4605-x

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