The risk of ovarian cancer after breast cancer in BRCA1 and BRCA2 carriers
The risk of ovarian cancer after breast cancer in BRCA1 and BRCA2 carriers
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DOI：
10.1016/j.ygyno.2004.09.039
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发表时间：
2005-01-01
影响因子：
4.7
通讯作者：
Narod, SA
中科院分区：
文献类型：
--
作者：
Metcalfe, KA;Lynch, HT;Narod, SA
Objective.评估BRCA 1或BRCA 2突变女性在乳腺癌初步诊断后患卵巢癌的风险，并确定可能改变风险的宿主和治疗相关因素。患者为491名I期或II期乳腺癌女性，诊断时间为1975年至2000年，并已确定BRCA 1或BRCA 2突变。患者从最初诊断为乳腺癌一直随访到卵巢癌、预防性卵巢切除术、死亡或2002年。对患者的医疗记录和病理学资料进行回顾性分析。从病历中提取的信息包括乳腺癌诊断日期、疾病分期、化疗的使用、放射治疗的使用、他莫昔芬的使用、卵巢切除术、复发、第二恶性肿瘤和生命状态。乳腺癌后卵巢癌的10年精算风险BRCA 1携带者为12.7%，BRCA 2携带者为6.8%（P 0.03）。使用他莫昔芬（OR = 1.79; P = 0.16）和化疗（OR = 0.59; P = 0.15）对后续卵巢癌的风险没有显著影响。25%的I期乳腺癌患者的死亡是由于随后的卵巢癌。卵巢癌的高发病率表明，卵巢切除术应建议女性BRCA 1和BRCA 2突变携带者诊断为乳腺癌，特别是那些与I期疾病。乳腺癌的系统治疗并没有显著改变卵巢癌的风险。(C)2004年爱思唯尔公司All rights reserved.
Objective. To estimate the risk of ovarian cancer after a primary diagnosis of breast cancer among women with a BRCA1 or BRCA2 mutation and to identify host and treatment-related factors that might modify the risk.Patients and methods. Patients were 491 women with stage I or stage II breast cancer, diagnosed from 1975 to 2000 and for whom a BRCA1 or BRCA2 mutation had been identified. Patients were followed from the initial diagnosis of breast cancer until either ovarian cancer, prophylactic oophorectomy, death, or 2002. The medical treatment records and pathology documents were reviewed. Information that was abstracted from the medical charts included date of breast cancer diagnosis, stage of disease, use of chemotherapy, use of radiation therapy, usage of tamoxifen, oophorectomy, recurrence, second malignancy, and vital status.Results. The 10-year actuarial risk of ovarian cancer after breast cancer was 12.7% for BRCA1 carriers and 6.8% for BRCA2 carriers (P 0.03). The use of tamoxifen (OR = 1.79; P = 0.16) and chemotherapy (OR = 0.59; P = 0.15) did not significantly impact on the risk of subsequent ovarian cancer. Twenty-five percent of the deaths in women with stage I breast cancer were due to a subsequent ovarian cancer.Conclusions. The high incidence of ovarian cancer suggests that oophorectomy should be recommended in female BRCA1 and BRCA2 mutation carriers with a diagnosis of breast cancer, especially those with stage I disease. Breast cancer systemic therapy did not significantly alter the risk of ovarian cancer. (C) 2004 Elsevier Inc. All rights reserved.