Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers

Kelly Metcalfe, Henry T. Lynch, Parviz Ghadirian, Nadine Tung, Charmaine Kim-Sing, Olufunmilayo I. Olopade, Susan Domchek, Andrea Eisen, William D. Foulkes, Barry Rosen, Danny Vesprini, Ping Sun, Steven A. Narod

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Abstract

Women with a BRCA1 or BRCA2 mutation have an elevated risk of breast cancer and of contralateral breast cancer. In this study, we estimate the risk of non-synchronous ipsilateral breast cancer after a diagnosis of breast cancer in BRCA carriers and evaluate the effects of various treatments on this risk. Patients were 396 women with stage I or stage II breast cancer with an intact ipsilateral breast and for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until the first of ipsilateral mastectomy, ipsilateral breast cancer, death or last follow-up. The 5-year actuarial risk of ipsilateral breast cancer was 5.8% (95% CI 3.2-8.4%) and the 10-year risk was 12.9% (95% CI 8.7-17.1%). Subjects who received chemotherapy had a significantly lower risk of ipsilateral breast cancer compared to those who did not receive chemotherapy (RR 0.45; 95% CI 0.24-0.84; P = 0.01). Radiotherapy was associated with a reduced risk of ipsilateral breast cancer (RR 0.28; 95% CI 0.12-0.63; P = 0.002). Oophorectomy was associated with a significant reduction in the risk of ipsilateral breast cancer (RR 0.33; 95% CI; 0.13-0.81; P = 0.02). On average, following a diagnosis of breast cancer, the annual risk of ipsilateral breast cancer risk in BRCA mutation carriers is 1.2% per year. For women treated with chemotherapy, radiation therapy or oophorectomy the risk is low, compared to women who did not receive any of these treatments.

Original languageEnglish
Pages (from-to)287-296
Number of pages10
JournalBreast Cancer Research and Treatment
Volume127
Issue number1
DOIs
StatePublished - May 2011

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Breast Neoplasms
Mutation
Ovariectomy
Drug Therapy
Radiotherapy
Mastectomy
Risk Reduction Behavior
Breast
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Metcalfe, K., Lynch, H. T., Ghadirian, P., Tung, N., Kim-Sing, C., Olopade, O. I., ... Narod, S. A. (2011). Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Research and Treatment, 127(1), 287-296. https://doi.org/10.1007/s10549-010-1336-7

Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers. / Metcalfe, Kelly; Lynch, Henry T.; Ghadirian, Parviz; Tung, Nadine; Kim-Sing, Charmaine; Olopade, Olufunmilayo I.; Domchek, Susan; Eisen, Andrea; Foulkes, William D.; Rosen, Barry; Vesprini, Danny; Sun, Ping; Narod, Steven A.

In: Breast Cancer Research and Treatment, Vol. 127, No. 1, 05.2011, p. 287-296.

Research output: Contribution to journalArticle

Metcalfe, K, Lynch, HT, Ghadirian, P, Tung, N, Kim-Sing, C, Olopade, OI, Domchek, S, Eisen, A, Foulkes, WD, Rosen, B, Vesprini, D, Sun, P & Narod, SA 2011, 'Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers', Breast Cancer Research and Treatment, vol. 127, no. 1, pp. 287-296. https://doi.org/10.1007/s10549-010-1336-7
Metcalfe, Kelly ; Lynch, Henry T. ; Ghadirian, Parviz ; Tung, Nadine ; Kim-Sing, Charmaine ; Olopade, Olufunmilayo I. ; Domchek, Susan ; Eisen, Andrea ; Foulkes, William D. ; Rosen, Barry ; Vesprini, Danny ; Sun, Ping ; Narod, Steven A. / Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers. In: Breast Cancer Research and Treatment. 2011 ; Vol. 127, No. 1. pp. 287-296.
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AU - Sun, Ping

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AB - Women with a BRCA1 or BRCA2 mutation have an elevated risk of breast cancer and of contralateral breast cancer. In this study, we estimate the risk of non-synchronous ipsilateral breast cancer after a diagnosis of breast cancer in BRCA carriers and evaluate the effects of various treatments on this risk. Patients were 396 women with stage I or stage II breast cancer with an intact ipsilateral breast and for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until the first of ipsilateral mastectomy, ipsilateral breast cancer, death or last follow-up. The 5-year actuarial risk of ipsilateral breast cancer was 5.8% (95% CI 3.2-8.4%) and the 10-year risk was 12.9% (95% CI 8.7-17.1%). Subjects who received chemotherapy had a significantly lower risk of ipsilateral breast cancer compared to those who did not receive chemotherapy (RR 0.45; 95% CI 0.24-0.84; P = 0.01). Radiotherapy was associated with a reduced risk of ipsilateral breast cancer (RR 0.28; 95% CI 0.12-0.63; P = 0.002). Oophorectomy was associated with a significant reduction in the risk of ipsilateral breast cancer (RR 0.33; 95% CI; 0.13-0.81; P = 0.02). On average, following a diagnosis of breast cancer, the annual risk of ipsilateral breast cancer risk in BRCA mutation carriers is 1.2% per year. For women treated with chemotherapy, radiation therapy or oophorectomy the risk is low, compared to women who did not receive any of these treatments.

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