Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Fujian Center for Disease Control and Prevention, Fuzhou, China.
Breast Cancer Res Treat. 2020 Apr;180(3):759-766. doi: 10.1007/s10549-020-05573-x. Epub 2020 Feb 18.
BRCA1/2 mutations represent a high risk of breast cancer and are related to early-onset breast cancer. However, few studies have reported the relationship between BRCA1/2 mutations and their clinical characteristics in early-onset breast cancers. This study is the first article that characterizes the risk factor profiles in Chinese patients selected by the age of onset (≤ 40 years old). We found some differences in the prevalence of germline BRCA1/2 mutations between Asian and Western countries.
A total of 1371 consecutive unselected Chinese early-onset breast cancer patients were enrolled from the Fujian Medical University Union Hospital, China, and screened for germline BRCA1/2 mutations. Full-exome sequencing in next-generation sequencing technology was performed in all patients to examine BRCA1/2 mutations.
In our study, 25 (1.8%) and 61 (4.4%) patients were identified with BRCA1 and BRCA2 mutations, respectively, among the unselected early-onset breast cancer patients. BRCA1 mutations were associated with pregnancies (p = 0.026), and BRCA1 carriers had a higher likelihood of being HR positive (p < 0.001), HER2 negative (p < 0.001), or high grade (p = 0.002) than noncarriers. Among BRCA2 mutations, the age of onset was younger in carriers than in noncarriers (p = 0.017), and BRCA2 carriers were more likely to have lymph node metastasis (p = 0.004). HR-positive or HER2-negative patients were likely to be positive for BRCA2 mutations (p < 0.001). Overall, 14 BRCA1 mutations and 8 BRCA2 mutations were first reported in our study CONCLUSION: This study provided some information about the spectrum of BRCA1/2 mutations and characterized the risk factors for early-onset breast cancer in China.
BRCA1/2 突变代表了乳腺癌的高风险,并且与早发性乳腺癌相关。然而,很少有研究报告 BRCA1/2 突变与早发性乳腺癌的临床特征之间的关系。本研究是第一篇通过发病年龄(≤40 岁)来描述中国患者风险因素特征的文章。我们发现亚洲和西方国家之间在种系 BRCA1/2 突变的流行率上存在一些差异。
我们从中国福建医科大学附属协和医院连续招募了 1371 例未经选择的早发性乳腺癌患者,并对其进行种系 BRCA1/2 突变筛查。所有患者均进行下一代测序技术的全外显子组测序以检查 BRCA1/2 突变。
在我们的研究中,在未经选择的早发性乳腺癌患者中,分别有 25(1.8%)和 61(4.4%)例患者被确定为 BRCA1 和 BRCA2 突变。BRCA1 突变与妊娠有关(p=0.026),BRCA1 携带者更有可能是 HR 阳性(p<0.001)、HER2 阴性(p<0.001)或高级别(p=0.002),而非携带者。在 BRCA2 突变中,携带者的发病年龄比非携带者年轻(p=0.017),BRCA2 携带者更有可能发生淋巴结转移(p=0.004)。HR 阳性或 HER2 阴性患者更有可能存在 BRCA2 突变(p<0.001)。总体而言,本研究首次报道了 14 个 BRCA1 突变和 8 个 BRCA2 突变。
本研究提供了有关 BRCA1/2 突变谱的一些信息,并描述了中国早发性乳腺癌的风险因素。