Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers

K. Metcalfe, S. Gershman, H. T. Lynch, P. Ghadirian, N. Tung, C. Kim-Sing, O. I. Olopade, S. Domchek, J. McLennan, A. Eisen, W. D. Foulkes, B. Rosen, P. Sun, S. A. Narod

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Abstract

Purpose:The objective of this study was to estimate the risk of contralateral breast cancer in BRCA1 and BRCA2 carriers; and measure the extent to which host, family history, and cancer treatment-related factors modify the risk.Patients and methods:Patients were 810 women, with stage I or 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: Overall, 149 subjects (18.4%) developed a contralateral breast cancer. The 15-year actuarial risk of contralateral breast cancer was 36.1% for women with a BRCA1 mutation and was 28.5% for women with a BRCA2 mutation. Women younger than 50 years of age at the time of breast cancer diagnosis were significantly more likely to develop a contralateral breast cancer at 15 years, compared with those older than 50 years (37.6 vs 16.8%; P0.003). Women aged 50 years with two or more first-degree relatives with early-onset breast cancer were at high risk of contralateral breast cancer, compared with women with fewer, or no first-degree relatives with breast cancer (50 vs 36%; P0.005). The risk of contralateral breast cancer was reduced with oophorectomy (RR 0.47; 95% CI 0.30-0.76; P0.002).Conclusion:The risk of contralateral breast cancer risk in BRCA mutation carriers declines with the age of diagnosis and increases with the number of first-degree relatives affected with breast cancer. Oophorectomy reduces the risk of contralateral breast cancer in young women with a BRCA mutation.

Original languageEnglish (US)
Pages (from-to)1384-1392
Number of pages9
JournalBritish Journal of Cancer
Volume104
Issue number9
DOIs
StatePublished - Apr 26 2011

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Metcalfe, K., Gershman, S., Lynch, H. T., Ghadirian, P., Tung, N., Kim-Sing, C., Olopade, O. I., Domchek, S., McLennan, J., Eisen, A., Foulkes, W. D., Rosen, B., Sun, P., & Narod, S. A. (2011). Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. British Journal of Cancer, 104(9), 1384-1392. https://doi.org/10.1038/bjc.2011.120