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Breast Cancer
Published in: Breast Cancer 2/2022

01-03-2022 | Mastectomy | Original Article

Breast-conserving therapy for breast cancer with BRCA mutations: a meta-analysis

Authors: Changjun Wang, Yan Lin, Hanjiang Zhu, Yidong Zhou, Feng Mao, Xin Huang, Xingtong Zhou, Xi Cao, Qiang Sun

Published in: Breast Cancer | Issue 2/2022

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Abstract

Background

BRCA1/2 mutated breast cancer accounts for 3 to 12% of all women with breast cancer and significantly increases the lifetime risk of breast cancer. However, the optimal local treatment for breast cancer with BRCA germline mutation remains controversial. Here we present a meta-analysis to evaluate the impact of breast-conserving therapy (BCT) on the prognosis of breast cancer with BRCA mutation.

Methods

Two independent reviewers searched Pubmed, Embase and Cochrane Central Register of Controlled Trials databases for relevant studies on BCT and BRCA mutated breast cancer. Fixed or random effect models were used for meta-analyses based on whether significant heterogeneity existed among included studies. Funnel plot and Begg’s test were employed for the evaluation of publication bias.

Results

Totally, four studies with five cohorts and a totally 1254 patients were included for meta-analyses. The BCT group involved more T0/T1 (BCT 63.7% Vs. M 48.9%, p < 0.001), N0 (BCT 70.5% Vs. M 56.2%, p < 0.001) and ER negative (BCT 58.8% Vs. M 49.3% p < 0.01) tumors than M group. Patients who received M tended to have prophylactic contralateral mastectomy (BCT 16.5% Vs. M 35.8%, p < 0.001). BCT had a significant higher risk for local recurrence than M (HR 3.838, 95% CI = 2.376–6.201, p < 0.001). The pooled results revealed no significant impact of BCT on disease-free survival (DFS), metastasis-free survival (MFS), breast cancer-specific survival (BCSS) and overall survival (OS).

Conclusions

The present meta-analysis suggested that BCT had increasing local recurrence risk, but did not significantly impact patient survival in terms of DFS, MFS, BCSS and OS. BCT may serve as a safe alternative to mastectomy for breast cancer with BRCA mutation. Further high-quality randomized control trials are warranted to explore the optimal surgical management for BRCA mutation carriers.
Appendix
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Metadata
Title
Breast-conserving therapy for breast cancer with BRCA mutations: a meta-analysis
Authors
Changjun Wang
Yan Lin
Hanjiang Zhu
Yidong Zhou
Feng Mao
Xin Huang
Xingtong Zhou
Xi Cao
Qiang Sun
Publication date
01-03-2022
Publisher
Springer Singapore
Published in
Breast Cancer / Issue 2/2022
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-021-01312-2

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