title: The risk of primary and contralateral breast cancer after ovarian cancer in BRCA1/BRCA2 mutation carriers: Implications for counseling.
abstract: BACKGROUND
  The objective of this study was to assess the incidence of primary breast cancer (PBC) and contralateral breast cancer (CBC) in patients who had BRCA1/BRCA2-associated epithelial ovarian cancer (OC).
  
  
  METHODS
  From the database of the Rotterdam Family Cancer Clinic, patients who had BRCA-associated OC without a history of unilateral breast cancer (BC) (at risk of PBC; n = 79) or with a history of unilateral BC (at risk of CBC; n = 37) were selected. The control groups consisted of unaffected BRCA mutation carriers (n = 351) or mutation carriers who had a previous unilateral BC (n = 294), respectively. The risks of PBC and CBC were calculated using the Kaplan-Meier survival method with death considered as a competing risk event.
  
  
  RESULTS
  Women with BRCA-associated OC had lower 2-year, 5-year, and 10-year risks of PBC (3%, 6%, and 11%, respectively) compared with unaffected mutation carriers (6%, 16%, and 28%, respectively; P = .03), although they had a considerably higher mortality rate at similar time points (13%, 33%, and 61%, respectively, vs 1%, 2%, and 2%, respectively; P < .001). In BRCA mutation carriers with a previous unilateral BC, the 2-year, 5-year, and 10-year risks of CBC were nonsignificantly lower in patients with OC than in those without OC (0%, 7%, and 7%, respectively, vs 6%, 16%, and 34%, respectively; P = .06), whereas the mortality rate was higher in patients with OC (19%, 34%, and 55%, respectively, vs 4%, 11%, and 21%, respectively; P < .001).
  
  
  CONCLUSIONS
  Patients with BRCA-associated OC had a lower risk of developing a subsequent PBC or CBC than mutation carriers without OC, whereas the risk of dying from OC was greater than the risk of developing BC. These data may facilitate more tailored counseling for this patient subgroup, although confirmative studies are warranted.
authors.affiliation: Department of Gynecological Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands.
authors.forename: Peggy M L H
authors.initials: PM
authors.lastname: Vencken
authors.forename: Mieke
authors.initials: M
authors.lastname: Kriege
authors.forename: Maartje
authors.initials: M
authors.lastname: Hooning
authors.forename: Marian B
authors.initials: MB
authors.lastname: Menke-Pluymers
authors.forename: Bernadette A M
authors.initials: BA
authors.lastname: Heemskerk-Gerritsen
authors.forename: Lena C
authors.initials: LC
authors.lastname: van Doorn
authors.forename: Margriet M
authors.initials: MM
authors.lastname: Collée
authors.forename: Agnes
authors.initials: A
authors.lastname: Jager
authors.forename: Cees
authors.initials: C
authors.lastname: van Montfort
authors.forename: Curt W
authors.initials: CW
authors.lastname: Burger
authors.forename: Caroline
authors.initials: C
authors.lastname: Seynaeve
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control / Q000556:secondary*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D006579:Heterozygote; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology; D012306:Risk; D055815:Young Adult