Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer
Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer
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DOI：
10.1002/cncr.27842
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发表时间：
2013-04-01
期刊：
影响因子：
6.2
通讯作者：
Robson, Mark
中科院分区：
文献类型：
--
作者：
Domchek, Susan M.;Jhaveri, Komal;Robson, Mark
背景技术背景：本研究旨在评估与BRCA 1/2（乳腺癌，早发）基因突变（BRCA-OC）相关的卵巢癌（OC）诊断后患乳腺癌（BC）的风险。方法：纪念斯隆-凯特琳癌症中心和宾夕法尼亚大学的临床遗传学数据库进行了检索，以确定1995年至2009年参加基因检测和随访研究的BRCA-OC女性。主要目的是确定BRCA-OC后发生BC的风险。总生存期（OS）和无BC生存期（BCFS）通过Kaplan-Meier方法确定;患者在末次随访时删失。结果：共有164例患者患有BRCA-OC（115例BRCA 1; 49例BRCA 2）。在这164例患者中，152例在BRCA检测前发生OC（检测中位时间为2.4年[0.01-55年]）。对于未发生BC的患者，OC的中位随访时间为5.8年（0.25-55.6年）。有46人死亡，但没有一个是由于BC。5年和10年OS分别为85%（95%置信区间[CI] = 0.78，0.90）和68%（95% CI = 0.59，0.76）。有18个异时CT诊断。5年和10年BCFS分别为97%（95% CI = 0.92，0.99）和91%（95% CI = 0.82，0.95）。64名女性在BRCA-OC之前或12个月内进行了测试。在该假事件子集中，5年和10年OS分别为71%（95% CI = 0.53，0.83）和62%（95% CI = 0.44，0.75），5年和10年BCFS分别为100%和87%（95% CI = 0.56，0.96）。结论：OC死亡占OS的主导地位。异时性BC风险低于未受影响的BRCA突变携带者。这些结果支持BRCA-OC女性患者BC风险的非手术管理。癌症2013年。(c)2012年美国癌症协会
BACKGROUND: This study sought to estimate the risk of breast cancer (BC) after a diagnosis of ovarian cancer (OC) associated with mutation of the BRCA1/2 (breast cancer, early onset) genes (BRCA-OC). METHODS: The Memorial Sloan-Kettering Cancer Center and the University of Pennsylvania, clinical genetics databases were searched to identify women with BRCA-OC who participated in genetic testing and follow-up studies from 1995 to 2009. The primary objective was to determine the risk of developing BC after BRCA-OC. Overall survival (OS) and BC-free survival (BCFS) were determined by the Kaplan-Meier method; patients were censored at the time of last follow-up. RESULTS: A total of 164 patients had BRCA-OC (115 with BRCA1; 49 with BRCA2). Of these 164 patients, 152 developed OC prior to BRCA testing (median time to testing, 2.4 years [0.01-55 years]). Median follow-up from OC for those not developing BC was 5.8 years (0.25-55.6 years). There were 46 deaths, but none were due to BC. The 5- and 10-year OS were 85% (95% confidence interval [CI] = 0.78, 0.90) and 68% (95% CI = 0.59, 0.76), respectively. There were 18 metachronous BC diagnoses. The 5- and 10-year BCFS were 97% (95% CI = 0.92, 0.99) and 91% (95% CI = 0.82, 0.95), respectively. A subset of 64 women were tested either before or within 12 months of BRCA-OC. In this pseudo-incident subset, 5- and 10- year OS was 71% (95% CI = 0.53, 0.83) and 62% (95% CI = 0.44, 0.75), respectively, and 5- and 10-year BCFS were 100% and 87% (95% CI = 0.56, 0.96), respectively. CONCLUSIONS: OS was dominated by OC deaths. Metachronous BC risk was lower than reported for unaffected BRCA mutation carriers. These results support nonsurgical management of BC risk in women with BRCA-OC. Cancer 2013. (c) 2012 American Cancer Society.