title: Comparison of nodal metastasis between BRCA mutation carriers and non-BRCA mutation carriers with breast cancer.
abstract: OBJECTIVE
  This study evaluates whether nodal status differs between breast cancer patients with BRCA mutations and those confirmed not to harbor mutations.
  
  
  METHODS
  A prospective database identified patients with breast cancer who underwent genetic testing and axillary staging. Comparative variables included age, as well as tumor characteristics such as size, grade, lymphovascular invasion (LVI), estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2-neu), and nodal status.
  
  
  RESULTS
  Overall, 235 patients with breast cancer underwent genetic testing for BRCA mutations from June 2000 to May 2012. Of these patients, 74 (31.4 %) were found to express BRCA 1 and/or 2 mutations, and 161 (68.5 %) patients were verified to have no detectable BRCA mutation. Among the entire 235 patients tested, 92 (39.1 %) were found to have nodal disease. In univariable analysis, only LVI and tumor size correlated with presence of nodal metastasis. Of the 74 BRCA mutation carriers, 34 (45.9 %) had nodal metastasis compared with 58 of the 161 (36 %; p = 0.15) patients without a BRCA mutation. BRCA mutation carriers with nodal disease were more likely to have poorly differentiated tumors than those without mutations who had nodal disease (24/33 [72.7 %] vs. 27/57 [47.4 %]; p = 0.027).
  
  
  CONCLUSIONS
  BRCA mutations are not themselves predictive of nodal metastasis. Patients with BRCA mutations did not have a statistically significant higher prevalence of nodal metastasis than those without mutations.
authors.affiliation: Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Shahrbanoo F
authors.initials: SF
authors.lastname: Noori
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gangi
authors.forename: Maria E
authors.initials: ME
authors.lastname: Nelson
authors.forename: Michael
authors.initials: M
authors.lastname: Choi
authors.forename: Parisa
authors.initials: P
authors.lastname: Mirzadehgan
authors.forename: Alison K
authors.initials: AK
authors.lastname: Bonk
authors.forename: James
authors.initials: J
authors.lastname: Mirocha
authors.forename: Farin
authors.initials: F
authors.lastname: Amersi
authors.forename: Armando E
authors.initials: AE
authors.lastname: Giuliano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000235:genetics* / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000235:genetics* / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005820:Genetic Testing; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D019313:BRCA1 Protein; D024682:BRCA2 Protein; D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C492913:BRCA1 protein, human; C551750:BRCA2 protein, human; C508053:ERBB2 protein, human