Outcomes and risk of subsequent breast events in breast‐conserving surgery patients with BRCA1 and BRCA2 mutation

Abstract

Purpose Previous studies provide inconsistent interpretations of the effect of inherited genetic factors on the survival and prognosis of patients with breast cancer. The aim of this study was to examine the effect of germline BRCA1 and BRCA2 mutation on survival and subsequent breast events in Chinese women who underwent breast‐conserving surgery. Methods A retrospective review of the clinical and pathological records was performed in patients diagnosed with primary invasive breast cancer between 2005 and 2018 in the cancer registry database. Clinicopathological data and data regarding treatment and outcomes, including date and site of disease progression, were collected. The survival outcomes and independent risk factors were conducted using SPSS. Results Overall, a total of 501 patients who underwent breast‐conserving surgery were identified and subjected to analyses, of which 63 cases with BRCA1 or BRCA2 mutation. The median age at diagnosis was 41 (range, 24‐74) for carriers and 37 (range, 17‐84) for noncarriers. After a median follow‐up time of 61 months (range, 8‐161) and 70 months (range, 0‐153), respectively, in carriers and noncarriers, the overall survival (P = .173) and disease‐free survival (P = .424) were not significantly different. Analogously, there was no significant difference between the two groups about the outcomes of ipsilateral breast tumor recurrence (P = .348), yet the contralateral breast cancer (CBC) was overt worse than noncarriers (P < .001). When adjusted to confounding factors, BRCA mutation was the only independent risk factors to CBC (HR = 7.89, P = .01). Conclusion In this study, BRCA mutation carriers have higher risk of CBC. And, BRCA mutation is the only independent risk factor to CBC. Therefore, intensive surveillance and follow‐up as well as more effective individual prevention are urgent. Decisions on alternatively effective prevention, especially the prevention of CBC, are urgent and should take into account patient prognosis and preferences.

Management of patients with BRCA mutation from the point of view of a breast surgeon

“…It has been argued that most ipsilateral events are new primary cancers [ 125 ]. There is however an increased risk of contralateral breast cancer in women with BRCA mutation [ 33 , [115] , [116] , [117] , 126 , 127 ]. The risk is estimated to 25–30% over 10 years and more than 40% over 15 years ([ 33 , 126 ]).…”

Effect of breast-conserving surgery combined with sentinel lymph node biopsy and axillary preservation on the recurrence, metastasis, complications and cosmetic results of early breast cancer patients

“…Through prospective randomized trials, related studies have confirmed that BCS combined with SLNB in patients with lymph node-negative breast cancer has a better physical and psychological impact on patients than previous axillary lymph node dissection treatment, and lower occurrence rate of complications (17,18). In this study, the results showed that patients undergoing BCS combined with SLBN and axillary preservation treatment experienced significantly lower operation times, intraoperative blood loss, and extubation times than did the control group, with the quality of life after treatment being better than that of the control group; also, 93.42% of patients in the combined group gave a good or excellent rating for the postoperative cosmetic result, which as significantly higher than that given by the control group (P<0.05); no significant difference was found in the recurrence and metastasis rate compared with the control group, which was consistent with the results of previous studies (19).…”

Prognostic Impact of BRCA1 and BRCA2 Mutations on Long-Term Survival Outcomes in Egyptian Female Breast Cancer Patients

“…By the age of 70 years, BRCA1 and BRCA2 carriers were previously found to have average cumulative risk of contralateral breast cancer of 83% and 62%, respectively [10]. Ye et al also showed higher risk of contralateral breast cancer in BRCA mutation carriers [39].…”