TY - JOUR
T1 - Should all BRCA1 mutation carriers with stage i breast cancer receive chemotherapy?
AU - Narod, Steven A.
AU - Metcalfe, Kelly
AU - Lynch, Henry T.
AU - Ghadirian, Parviz
AU - Robidoux, Andre
AU - Tung, Nadine
AU - Gaughan, Elizabeth
AU - Kim-Sing, Charmaine
AU - Olopade, Olufunmilayo I.
AU - Foulkes, William D.
AU - Robson, Mark
AU - Offit, Kenneth
AU - Jakubowska, Ania
AU - Byrski, Tomasz
AU - Huzarski, Tomasz
AU - Sun, Ping
AU - Lubinski, Jan
N1 - Funding Information:
Acknowledgments We thank Fonds de la recherche en santé du Québec (FRSQ), the Canadian Breast Cancer Research Alliance and the Canadian Breast Cancer Foundation (Ontario Chapter) for their support. Also supported by the Polish Ministries of Science and Health.
PY - 2013/2
Y1 - 2013/2
N2 - To estimate the 15-year survival following a diagnosis of stage I breast cancer among women who carry a BRCA1 mutation and to determine predictors of mortality, including the use of chemotherapy. Patients were 379 women with stage I breast cancer for whom a BRCA1 mutation had been identified, in herself or in a close family member. Patients were followed for up to 15 years from the initial diagnosis of breast cancer. Survival rates were estimated for women by age, tumor size (≤1 cm; >1 cm), ER status (±), and by chemotherapy (yes/no). 42 women died of breast cancer in the follow-up period (11.2 %). Survival rates were similar for women with cancers of size 0-1.0 cm and size 1.1-2.0 cm. Of the 267 women in the study who used chemotherapy, 21 had died (7.9 %) compared to 21 deaths among 112 women who did not receive chemotherapy (18.8 %; p = 0.002). The 15-year survival was 89.4 % for women who received chemotherapy and was 73.1 % for women who did not receive chemotherapy (p = 0.08; log rank). The adjusted hazard ratio for death following a diagnosis of stage I breast cancer associated with chemotherapy was 0.53 (95 % CI 0.28-1.07; p value 0.06) after adjusting for age of diagnosis, tumor size, and estrogen receptor status. This was statistically significant only among women with ER-negative breast cancers (HR = 0.28; 95 % CI 0.10-0.79; p = 0.02). BRCA1 positive women who are treated for stage I breast cancer with chemotherapy have better survival than those who do not receive chemotherapy. The difference cannot be explained by other prognostic factors. All women with invasive breast cancer and a BRCA1 mutation should be considered to be candidates for chemotherapy.
AB - To estimate the 15-year survival following a diagnosis of stage I breast cancer among women who carry a BRCA1 mutation and to determine predictors of mortality, including the use of chemotherapy. Patients were 379 women with stage I breast cancer for whom a BRCA1 mutation had been identified, in herself or in a close family member. Patients were followed for up to 15 years from the initial diagnosis of breast cancer. Survival rates were estimated for women by age, tumor size (≤1 cm; >1 cm), ER status (±), and by chemotherapy (yes/no). 42 women died of breast cancer in the follow-up period (11.2 %). Survival rates were similar for women with cancers of size 0-1.0 cm and size 1.1-2.0 cm. Of the 267 women in the study who used chemotherapy, 21 had died (7.9 %) compared to 21 deaths among 112 women who did not receive chemotherapy (18.8 %; p = 0.002). The 15-year survival was 89.4 % for women who received chemotherapy and was 73.1 % for women who did not receive chemotherapy (p = 0.08; log rank). The adjusted hazard ratio for death following a diagnosis of stage I breast cancer associated with chemotherapy was 0.53 (95 % CI 0.28-1.07; p value 0.06) after adjusting for age of diagnosis, tumor size, and estrogen receptor status. This was statistically significant only among women with ER-negative breast cancers (HR = 0.28; 95 % CI 0.10-0.79; p = 0.02). BRCA1 positive women who are treated for stage I breast cancer with chemotherapy have better survival than those who do not receive chemotherapy. The difference cannot be explained by other prognostic factors. All women with invasive breast cancer and a BRCA1 mutation should be considered to be candidates for chemotherapy.
UR - http://www.scopus.com/inward/record.url?scp=84874665352&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874665352&partnerID=8YFLogxK
U2 - 10.1007/s10549-013-2429-x
DO - 10.1007/s10549-013-2429-x
M3 - Article
C2 - 23381743
AN - SCOPUS:84874665352
VL - 138
SP - 273
EP - 279
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 1
ER -