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The risk of primary and contralateral breast cancer after ovarian cancer in BRCA1/BRCA2 mutation carriers
Abstract
BACKGROUND:
The
objective of this study was to assess the incidence of primary breast
cancer (PBC) and contralateral breast cancer (CBC) in patients who had BRCA1/BRCA2-associated epithelial ovarian cancer (OC).
METHODS:
From the database of the Rotterdam Family Cancer Clinic, patients who had BRCA-associated
OC without a history of unilateral breast cancer (BC) (at risk of PBC; n
= 79) or with a history of unilateral BC (at risk of CBC; n = 37) were
selected. The control groups consisted of unaffected BRCA
mutation carriers (n = 351) or mutation carriers who had a previous
unilateral BC (n = 294), respectively. The risks of PBC and CBC were
calculated using the Kaplan-Meier survival method with death considered
as a competing risk event.
RESULTS:
Women with BRCA-associated
OC had lower 2-year, 5-year, and 10-year risks of PBC (3%, 6%, and 11%,
respectively) compared with unaffected mutation carriers (6%, 16%, and
28%, respectively; P = .03), although they had a considerably
higher mortality rate at similar time points (13%, 33%, and 61%,
respectively, vs 1%, 2%, and 2%, respectively; P < .001). In BRCA
mutation carriers with a previous unilateral BC, the 2-year, 5-year,
and 10-year risks of CBC were nonsignificantly lower in patients with OC
than in those without OC (0%, 7%, and 7%, respectively, vs 6%, 16%, and
34%, respectively; P = .06), whereas the mortality rate was
higher in patients with OC (19%, 34%, and 55%, respectively, vs 4%, 11%,
and 21%, respectively; P < .001).
CONCLUSIONS:
Patients with BRCA-associated
OC had a lower risk of developing a subsequent PBC or CBC than mutation
carriers without OC, whereas the risk of dying from OC was greater than
the risk of developing BC. These data may facilitate more tailored
counseling for this patient subgroup, although confirmative studies are
warranted. Cancer 2012. © 2012 American Cancer Society.
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