Department of Gynecological Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands.
Cancer. 2013 Mar 1;119(5):955-62. doi: 10.1002/cncr.27839. Epub 2012 Nov 16.
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).
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.
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).
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.
本研究旨在评估携带 BRCA1/BRCA2 基因突变的上皮性卵巢癌（OC）患者中发生原发性乳腺癌（PBC）和对侧乳腺癌（CBC）的风险。
从鹿特丹家族癌症诊所的数据库中，选择无单侧乳腺癌（BC）病史（有发生 PBC 的风险；n=79）或有单侧 BC 病史（有发生 CBC 的风险；n=37）的 BRCA 相关 OC 患者。对照组分别由未受影响的 BRCA 突变携带者（n=351）或之前有单侧 BC 的突变携带者（n=294）组成。使用 Kaplan-Meier 生存法计算 PBC 和 CBC 的风险，以死亡作为竞争风险事件。
与未受影响的突变携带者相比，携带 BRCA 相关 OC 的女性发生 PBC 的 2 年、5 年和 10 年风险较低（分别为 3%、6%和 11%，分别为 6%、16%和 28%；P=0.03），尽管她们在相似的时间点死亡率较高（分别为 13%、33%和 61%，分别为 1%、2%和 2%；P<0.001）。在之前有单侧 BC 的 BRCA 突变携带者中，OC 患者的 2 年、5 年和 10 年 CBC 风险与无 OC 的患者相比无显著差异（分别为 0%、7%和 7%，分别为 6%、16%和 34%；P=0.06），但 OC 患者的死亡率较高（分别为 19%、34%和 55%，分别为 4%、11%和 21%；P<0.001）。
与无 OC 的突变携带者相比，携带 BRCA 相关 OC 的患者发生 PBC 或 CBC 的风险较低，而死于 OC 的风险高于发生 BC 的风险。这些数据可能为这一患者亚组提供更有针对性的咨询，但需要进一步的证实性研究。
Zotero 插件