Survival from breast cancer in women with a BRCA2 mutation by treatment |
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Authors: | D. Gareth Evans,Kelly-Anne Phillips,Roger L. Milne,Robert Fruscio,Cezary Cybulski,Jacek Gronwald,Jan Lubinski,Tomasz Huzarski,Zerin Hyder,Claire Forde,Kelly Metcalfe,Leigha Senter,Jeffrey Weitzel,Nadine Tung,Dana Zakalik,Maria Ekholm,Ping Sun,Steven A. Narod,kConFab Investigators,Polish Hereditary Breast Cancer Consortium,Hereditary Breast Cancer Clinical Study Group |
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Abstract: | Background The impact of various breast-cancer treatments on patients with a BRCA2 mutation has not been studied. We sought to estimate the impact of bilateral oophorectomy and other treatments on breast cancer-specific survival among patients with a germline BRCA2 mutation.Methods We identified 664 women with stage I–III breast cancer and a BRCA2 mutation by combining five different datasets (retrospective and prospective). Subjects were followed for 7.2 years from diagnosis to death from breast cancer. Tumour characteristics and cancer treatments were patient-reported and derived from medical records. Predictors of survival were determined using Cox proportional hazard models, adjusted for other treatments and for prognostic features.Results The 10-year breast-cancer survival for ER-positive patients was 78.9% and for ER-negative patients was 82.3% (adjusted HR = 1.23 (95% CI, 0.62–2.45, p = 0.55)). The 10-year breast-cancer survival for women who had a bilateral oophorectomy was 89.1% and for women who did not have an oophorectomy was 59.0% (adjusted HR = 0.45; 95% CI, 0.28–0.72, p = 0.001). The adjusted hazard ratio for chemotherapy was 0.83 (95% CI, 0.65–1.53: p = 0.56).Conclusions For women with breast cancer and a germline BRCA2 mutation, positive ER status does not predict superior survival. Oophorectomy is associated with a reduced risk of death from breast cancer and should be considered in the treatment plan.Subject terms: Targeted therapies, Breast cancer |
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