Women's College Research Institute, Toronto, ON, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Br J Cancer. 2019 Feb;120(4):398-403. doi: 10.1038/s41416-019-0376-y. Epub 2019 Feb 6.
To evaluate the predictors of mortality, including ER status, in women with a BRCA2 mutation and breast cancer.
Eligible participants were identified from within two longitudinal cohorts. These patients were selected because they were diagnosed with breast cancer between 1975 and 2015 and carried a BRCA2 mutation. Data were abstracted from the medical record and pathology report. We analysed the effects of ER status and other variables on breast cancer specific survival using a Cox proportional hazards model.
Three hundred ninety women with breast cancer and a BRCA2 mutation were included in the analysis. The mean follow-up time was 12.3 years (range 1-39 years) and 89 subjects died (22.8%). In the multivariate analysis, women with ER-positive tumours were more likely to die than women with ER-negative tumours (HR 2.08, 95% CI 0.99-4.36, p = 0.05), and this was of borderline significance. For the 233 women with ER-positive tumours the 20-year survival rate was 62.2%, compared to 83.7% for 58 women with ER-negative tumours (p = 0.03).
The majority of women with a BRCA2 mutation present with ER-positive breast cancer, and for these women, prognosis may be worse than for BRCA2 carriers with ER-negative breast cancer.
评估包括 ER 状态在内的死亡率预测因素,这些患者患有 BRCA2 突变和乳腺癌。
从两个纵向队列中确定符合条件的参与者。选择这些患者是因为他们在 1975 年至 2015 年间被诊断出患有乳腺癌并携带 BRCA2 突变。数据从病历和病理报告中提取。我们使用 Cox 比例风险模型分析 ER 状态和其他变量对乳腺癌特异性生存的影响。
在分析中纳入了 390 名患有乳腺癌和 BRCA2 突变的女性。平均随访时间为 12.3 年(范围 1-39 年),89 人死亡(22.8%)。在多变量分析中,ER 阳性肿瘤的女性比 ER 阴性肿瘤的女性更有可能死亡(HR 2.08,95%CI 0.99-4.36,p=0.05),这具有边界显著性。对于 233 名 ER 阳性肿瘤的女性,20 年生存率为 62.2%,而 58 名 ER 阴性肿瘤的女性为 83.7%(p=0.03)。
大多数携带 BRCA2 突变的女性表现为 ER 阳性乳腺癌,对于这些女性,预后可能比 ER 阴性乳腺癌的 BRCA2 携带者更差。