Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer Journal Article


Authors: Domchek, S. M.; Jhaveri, K.; Patil, S.; Stopfer, J. E.; Hudis, C.; Powers, J.; Stadler, Z.; Goldstein, L.; Kauff, N.; Khasraw, M.; Offit, K.; Nathanson, K. L.; Robson, M.
Article Title: Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer
Abstract: BACKGROUND: This study sought to estimate the risk of breast cancer (BC) after a diagnosis of ovarian cancer (OC) associated with mutation of the BRCA1/2 (breast cancer, early onset) genes (BRCA-OC). METHODS: The Memorial Sloan-Kettering Cancer Center and the University of Pennsylvania, clinical genetics databases were searched to identify women with BRCA-OC who participated in genetic testing and follow-up studies from 1995 to 2009. The primary objective was to determine the risk of developing BC after BRCA-OC. Overall survival (OS) and BC-free survival (BCFS) were determined by the Kaplan-Meier method; patients were censored at the time of last follow-up. RESULTS: A total of 164 patients had BRCA-OC (115 with BRCA1; 49 with BRCA2). Of these 164 patients, 152 developed OC prior to BRCA testing (median time to testing, 2.4 years [0.01-55 years]). Median follow-up from OC for those not developing BC was 5.8 years (0.25-55.6 years). There were 46 deaths, but none were due to BC. The 5- and 10-year OS were 85% (95% confidence interval [CI] = 0.78, 0.90) and 68% (95% CI = 0.59, 0.76), respectively. There were 18 metachronous BC diagnoses. The 5- and 10-year BCFS were 97% (95% CI = 0.92, 0.99) and 91% (95% CI = 0.82, 0.95), respectively. A subset of 64 women were tested either before or within 12 months of BRCA-OC. In this pseudo-incident subset, 5- and 10- year OS was 71% (95% CI = 0.53, 0.83) and 62% (95% CI = 0.44, 0.75), respectively, and 5- and 10-year BCFS were 100% and 87% (95% CI = 0.56, 0.96), respectively. CONCLUSIONS: OS was dominated by OC deaths. Metachronous BC risk was lower than reported for unaffected BRCA mutation carriers. These results support nonsurgical management of BC risk in women with BRCA-OC. Cancer 2013. © 2012 American Cancer Society. The risk of breast cancer after BRCA (breast cancer, early onset) mutation-associated breast cancer does not justify a surgical approach to prevention in women with this mutation. Survival is dominated by ovarian cancer deaths. Copyright © 2012 American Cancer Society.
Keywords: ovarian cancer; breast cancer; brca1; brca2; second primary; metachronous
Journal Title: Cancer
Volume: 119
Issue: 7
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2013-04-01
Start Page: 1344
End Page: 1348
Language: English
PROVIDER: scopus
PUBMED: 23165893
DOI: 10.1002/cncr.27842
DOI/URL:
Notes: --- - "Export Date: 1 May 2013" - "CODEN: CANCA" - ":doi 10.1002/cncr.27842" - "Source: Scopus"
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  1. Sujata Patil
    511 Patil
  2. Kenneth Offit
    789 Offit
  3. Clifford Hudis
    905 Hudis
  4. Mark E Robson
    676 Robson
  5. Noah Kauff
    128 Kauff
  6. Zsofia Kinga Stadler
    391 Stadler
  7. Komal Lachhman Jhaveri
    202 Jhaveri