 |  | 

ABSTRACT: Survival in prospectively ascertained familial breast
cancer: Analysis of a series stratified by tumour characteristics,
BRCA mutations and oophorectomy
Dedicated clinics have been established for the early diagnosis and treatment
of women at risk for inherited breast cancer, but the effects
of such interventions are currently unproven.
This second report
on prospectively diagnosed inherited breast cancer from the European
collaborating centres supports the previous conclusions and adds
information on genetic heterogeneity and the effect of oophorectomy.
Of 249 patients, 20% had carcinoma in situ (CIS), 54% had infiltrating
cancer without spread (CaN0) and 26% had cancer with spread (CaN+).
Five-year survival was 100% for CIS, 94% for CaN0 and 72% for
CaN+ (p = 0.007). Thirty-six patients had BRCA1 mutations, and
8 had BRCA2 mutations.
Presence of BRCA1 mutation was associated
with infiltrating cancer, high grade and lack of oestrogen receptor
(p < 0.05 for all 3 characteristics). For BRCA1 mutation carriers,
5-year survival was 63% vs. 91% for noncarriers (p = 0.04). For
CaN0 patients, mutation carriers had 75% 5-year disease-free
survival vs. 96% for noncarriers (p = 0.01).
Twenty-one of the
mutation carriers had undergone prophylactic oophorectomy, prior
to or within 6 months of diagnosis in 13 cases. All but 1 relapse
occurred in the 15 who had kept their ovaries, (p < 0.01);
no relapse occurred in those who had removed the ovaries within
6 months (p = 0.04)
Contralateral cancer was more frequently
observed in mutation noncarriers, but this finding did not reach
statistical significance. Our findings support the concept that
BRCA1 cancer is biologically different from other inherited breast
cancers.
While current screening protocols appear satisfactory
for the majority of women at risk of familial breast cancer,
this may not be the case for BRCA1 mutation carriers.
The observed
effect of oophorectomy was striking.
[09/20/2002; International Journal of Cancer]
|
Remember we are NOT Doctors and have NO medical training.
This site is like an Encylopedia - there are many pages, many links on many topics.
Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM. |
|