Similar Prognosis for BRCA1 Carriers, Sporadic Breast Cancer

For BRCA2 carriers, outcomes worse in univariable but similar in multivariable analyses

THURSDAY, Dec. 8 (HealthDay News) -- The risks of distant recurrence and death are similar for BRCA1 mutation carriers and for those with sporadic breast cancer, whereas women with BRCA2 mutations have higher risks on univariable analysis, and similar risks on multivariable analysis, according to a study published online Dec. 5 in the Journal of Clinical Oncology.

Pamela J. Goodwin, M.D., from Mount Sinai Hospital in Toronto, and colleagues compared breast cancer prognosis for BRCA1 and BRCA2 mutation carriers with that of patients with sporadic disease. A total of 3,220 women (mean age at diagnosis, 45.3 years) with incident breast cancer identified between 1995 and 2000 were included. Of them, 93 and 71 had BRCA1 mutations and BRCA2 mutations, respectively; one had both mutations; and 1,550 and 1,505 had sporadic breast cancer and familial breast cancer without known BRCA1/2 mutations, respectively. During a mean follow-up period of 7.9 years, distant recurrence and death were analyzed.

The investigators found that, in univariable and multivariable analyses, there were no significant differences in the risks of distant recurrence and death between BRCA1 mutation carriers and those with sporadic disease. In univariable analysis, BRCA2 mutation carriers had a significantly higher risk of distant recurrence and death compared to those with sporadic disease (hazard ratios [HRs], 1.63 and 1.81, respectively). No differences were seen for distant recurrence or death after adjusting for age, tumor stage and grade, nodal status, hormone receptors, and year of diagnosis (HRs, 1.00 [P = 1.00] and 1.12 [P = 0.64], respectively).

"Worse outcomes in BRCA2 mutation carriers in univariable analysis seem to reflect the presence of more adverse tumor characteristics in these carriers," the authors write.

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