Ten-year survival in patients with BRCA1-negative and BRCA1-positive breast cancer.
OBJECTIVE
To estimate 10-year overall survival (OS) rates for patients with early-onset breast cancer, with and without a BRCA1 mutation, and to identify prognostic factors among those with BRCA1-positive breast cancer.


METHODS
A total of 3,345 women with stage I to III breast cancer, age ≤ 50 years, were tested for three founder mutations in BRCA1. Information on tumor characteristics and treatments received was retrieved from medical records. Dates of death were obtained from the vital statistics registry. Survival curves for the mutation-positive and -negative subcohorts were compared. Predictors of OS were determined using the Cox proportional hazards model.


RESULTS
Of the 3,345 patients enrolled onto the study, 233 (7.0%) carried a BRCA1 mutation. The 10-year survival rate for mutation carriers was 80.9% (95% CI, 75.4% to 86.4%); for noncarriers, it was 82.2% (95% CI, 80.5% to 83.7%). The adjusted hazard ratio (HR) associated with carrying a BRCA1 mutation was 1.81 (95% CI, 1.26 to 2.61). Among BRCA1 carriers with a small (< 2 cm) node-negative tumor, the 10-year survival rate was 89.9%. Among BRCA1 mutation carriers, positive lymph node status was a strong predictor of mortality (adjusted HR, 4.1; 95% CI, 1.8 to 8.9). Oophorectomy was associated with improved survival in BRCA1 carriers (adjusted HR, 0.30; 95% CI, 0.12 to 0.75).


CONCLUSIONS
The 10-year survival rate among women with breast cancer and a BRCA1 mutation is similar to that of patients without a BRCA1 mutation. Among women with a BRCA1 mutation, survival was much improved after oophorectomy.
Tomasz Huzarski, Tomasz Byrski, Jacek Gronwald, Bohdan Górski, Pawel Domagała, Cezary Cybulski, Oleg Oszurek, and Jan Lubiński, Pomeranian Medical University, Szczecin; Marek Szwiec, Regional Oncology Center, Opole; Karol Gugała, District Specialist Hospital, Olsztyn; Malgorzata Stawicka, Regional Oncology Center, Poznań; Zbigniew Morawiec, Regional Oncology Center, Łódź; Tomasz Mierzwa, Regional Oncology Hospital; Hanna Janiszewska, Nicolaus Copernicus University, Bydgoszcz; Ewa Kilar, District Specialist Hospital, Świdnica; Elzbieta Marczyk, Regional Oncology Center, Kraków; Beata Kozak-Klonowska and Monika Siołek, Regional Oncology Center, Kielce; Dariusz Surdyka, St John's Cancer Center, Lublin; Rafal Wiśniowski, Regional Oncology Hospital, Bielsko Biała; Michal Posmyk, Regional Oncology Center, Białystok, Poland; and Ping Sun and Steven A. Narod, Women's College Research Institute, Toronto, Ontario, Canada.
Tomasz
T
Huzarski
Tomasz
T
Byrski
Jacek
J
Gronwald
Bohdan
B
Górski
Pawel
P
Domagala
Cezary
C
Cybulski
Oleg
O
Oszurek
Marek
M
Szwiec
Karol
K
Gugala
Malgorzata
M
Stawicka
Zbigniew
Z
Morawiec
Tomasz
T
Mierzwa
Hanna
H
Janiszewska
Ewa
E
Kilar
Elzbieta
E
Marczyk
Beata
B
Kozak-Klonowska
Monika
M
Siolek
Dariusz
D
Surdyka
Rafal
R
Wisniowski
Michal
M
Posmyk
Ping
P
Sun
Jan
J
Lubinski
Steven A
SA
Narod
D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000235:genetics / Q000401:mortality* / Q000601:surgery; D010052:Ovariectomy / Q000401:mortality; D011379:Prognosis; D012042:Registries; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human