Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers

Kelly Metcalfe, Henry T. Lynch, Parviz Ghadirian, Nadine Tung, Ivo Olivotto, Ellen Warner, Olufunmilayo I. Olopade, Andrea Eisen, Barbara Weber, Jane McLennan, Ping Sun, William D. Foulkes, Steven A. Narod

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Abstract

Purpose: To estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers after diagnosis and to determine which factors are predictive of the risk of a second primary breast cancer. Patients and Methods: Patients included 491 women with stage I or stage II breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up. Results: The actuarial risk of contralateral breast cancer was 29.5% at 10 years. Factors that were predictive of a reduced risk were the presence of a BRCA2 mutation (v BRCA1 mutation; hazard ratio [HR], 0.73; 95% CI, 0.47 to 1.15); age 50 years or older at first diagnosis (v ≤ 49 years; HR, 0.63; 95% CI, 0.36 to 1.10); use of tamoxifen (HR, 0.59; 95% CI, 0.35 to 1.01); and history of oophorectomy (HR, 0.44; 95% CI, 0.21 to 0.91). The effect of oophorectomy was particularly strong in women first diagnosed prior to age 49 years (HR, 0.24; 95% CI, 0.07 to 0.77). For women who did not have an oophorectomy or take tamoxifen, the 10-year risk of contralateral cancer was 43.4% for BRCA1 carriers and 34.6% for BRCA2 carriers. Conclusion: The risk of contralateral breast cancer in women with a BRCA mutation is approximately 40% at 10 years, and is reduced in women who take tamoxifen or who undergo an oophorectomy.

Original languageEnglish
Pages (from-to)2328-2335
Number of pages8
JournalJournal of Clinical Oncology
Volume22
Issue number12
DOIs
StatePublished - 2004

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Ovariectomy
Breast Neoplasms
Mutation
Tamoxifen
Second Primary Neoplasms
Mastectomy
Neoplasms

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Metcalfe, K., Lynch, H. T., Ghadirian, P., Tung, N., Olivotto, I., Warner, E., ... Narod, S. A. (2004). Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. Journal of Clinical Oncology, 22(12), 2328-2335. https://doi.org/10.1200/JCO.2004.04.033

Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. / Metcalfe, Kelly; Lynch, Henry T.; Ghadirian, Parviz; Tung, Nadine; Olivotto, Ivo; Warner, Ellen; Olopade, Olufunmilayo I.; Eisen, Andrea; Weber, Barbara; McLennan, Jane; Sun, Ping; Foulkes, William D.; Narod, Steven A.

In: Journal of Clinical Oncology, Vol. 22, No. 12, 2004, p. 2328-2335.

Research output: Contribution to journalArticle

Metcalfe, K, Lynch, HT, Ghadirian, P, Tung, N, Olivotto, I, Warner, E, Olopade, OI, Eisen, A, Weber, B, McLennan, J, Sun, P, Foulkes, WD & Narod, SA 2004, 'Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers', Journal of Clinical Oncology, vol. 22, no. 12, pp. 2328-2335. https://doi.org/10.1200/JCO.2004.04.033
Metcalfe, Kelly ; Lynch, Henry T. ; Ghadirian, Parviz ; Tung, Nadine ; Olivotto, Ivo ; Warner, Ellen ; Olopade, Olufunmilayo I. ; Eisen, Andrea ; Weber, Barbara ; McLennan, Jane ; Sun, Ping ; Foulkes, William D. ; Narod, Steven A. / Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 12. pp. 2328-2335.
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abstract = "Purpose: To estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers after diagnosis and to determine which factors are predictive of the risk of a second primary breast cancer. Patients and Methods: Patients included 491 women with stage I or stage II breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up. Results: The actuarial risk of contralateral breast cancer was 29.5{\%} at 10 years. Factors that were predictive of a reduced risk were the presence of a BRCA2 mutation (v BRCA1 mutation; hazard ratio [HR], 0.73; 95{\%} CI, 0.47 to 1.15); age 50 years or older at first diagnosis (v ≤ 49 years; HR, 0.63; 95{\%} CI, 0.36 to 1.10); use of tamoxifen (HR, 0.59; 95{\%} CI, 0.35 to 1.01); and history of oophorectomy (HR, 0.44; 95{\%} CI, 0.21 to 0.91). The effect of oophorectomy was particularly strong in women first diagnosed prior to age 49 years (HR, 0.24; 95{\%} CI, 0.07 to 0.77). For women who did not have an oophorectomy or take tamoxifen, the 10-year risk of contralateral cancer was 43.4{\%} for BRCA1 carriers and 34.6{\%} for BRCA2 carriers. Conclusion: The risk of contralateral breast cancer in women with a BRCA mutation is approximately 40{\%} at 10 years, and is reduced in women who take tamoxifen or who undergo an oophorectomy.",
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T1 - Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers

AU - Metcalfe, Kelly

AU - Lynch, Henry T.

AU - Ghadirian, Parviz

AU - Tung, Nadine

AU - Olivotto, Ivo

AU - Warner, Ellen

AU - Olopade, Olufunmilayo I.

AU - Eisen, Andrea

AU - Weber, Barbara

AU - McLennan, Jane

AU - Sun, Ping

AU - Foulkes, William D.

AU - Narod, Steven A.

PY - 2004

Y1 - 2004

N2 - Purpose: To estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers after diagnosis and to determine which factors are predictive of the risk of a second primary breast cancer. Patients and Methods: Patients included 491 women with stage I or stage II breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up. Results: The actuarial risk of contralateral breast cancer was 29.5% at 10 years. Factors that were predictive of a reduced risk were the presence of a BRCA2 mutation (v BRCA1 mutation; hazard ratio [HR], 0.73; 95% CI, 0.47 to 1.15); age 50 years or older at first diagnosis (v ≤ 49 years; HR, 0.63; 95% CI, 0.36 to 1.10); use of tamoxifen (HR, 0.59; 95% CI, 0.35 to 1.01); and history of oophorectomy (HR, 0.44; 95% CI, 0.21 to 0.91). The effect of oophorectomy was particularly strong in women first diagnosed prior to age 49 years (HR, 0.24; 95% CI, 0.07 to 0.77). For women who did not have an oophorectomy or take tamoxifen, the 10-year risk of contralateral cancer was 43.4% for BRCA1 carriers and 34.6% for BRCA2 carriers. Conclusion: The risk of contralateral breast cancer in women with a BRCA mutation is approximately 40% at 10 years, and is reduced in women who take tamoxifen or who undergo an oophorectomy.

AB - Purpose: To estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers after diagnosis and to determine which factors are predictive of the risk of a second primary breast cancer. Patients and Methods: Patients included 491 women with stage I or stage II breast cancer, for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until contralateral mastectomy, contralateral breast cancer, death, or last follow-up. Results: The actuarial risk of contralateral breast cancer was 29.5% at 10 years. Factors that were predictive of a reduced risk were the presence of a BRCA2 mutation (v BRCA1 mutation; hazard ratio [HR], 0.73; 95% CI, 0.47 to 1.15); age 50 years or older at first diagnosis (v ≤ 49 years; HR, 0.63; 95% CI, 0.36 to 1.10); use of tamoxifen (HR, 0.59; 95% CI, 0.35 to 1.01); and history of oophorectomy (HR, 0.44; 95% CI, 0.21 to 0.91). The effect of oophorectomy was particularly strong in women first diagnosed prior to age 49 years (HR, 0.24; 95% CI, 0.07 to 0.77). For women who did not have an oophorectomy or take tamoxifen, the 10-year risk of contralateral cancer was 43.4% for BRCA1 carriers and 34.6% for BRCA2 carriers. Conclusion: The risk of contralateral breast cancer in women with a BRCA mutation is approximately 40% at 10 years, and is reduced in women who take tamoxifen or who undergo an oophorectomy.

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DO - 10.1200/JCO.2004.04.033

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