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Familial breast cancer: an investigation into the outcome of treatment for early stage disease

Familial breast cancer: an investigation into the outcome of treatment for early stage disease
Familial breast cancer: an investigation into the outcome of treatment for early stage disease
The purpose of this study was to retrospectively compare the outcomes of treatment in 304 women with familial and sporadic breast cancer to clarify the options for the primary management of familial breast cancer. The majority of women were consecutively ascertained on the basis of either breast cancer diagnosed at age < 40 years or bilateral breast cancer. In addition, known BRCA1 mutation carriers were identified through the genetics services in participating centres. These patients were subdivided into those with a significant family history of breast cancer or known BRCA1 mutation (FH+) and those with no significant family history (FH–). There were no significant differences in age, surgical treatment or adjuvant treatment between the two groups, but there were significantly more women whose nodal status was unknown in the FH+ group. Ipsilateral recurrence occurred in 22.2% of FH+ patients compared with 24.1% of FH– patients (p = 0.774) who underwent breast conserving surgery. There was a striking excess of contralateral breast cancers in the FH+ group (35.9% v 16%, p = 0.0007), with a cumulative risk of contralateral cancer of 36% at 10 years. This was reflected in a non-significant trend toward worse relapse free survival in the FH+ group (p = 0.0563), but no difference was observed in overall survival between the two patient groups (p = 0.142). Similarly, for patients with known BRCA1 mutations, contralateral recurrence occurred more frequently, but other outcomes were not significantly different from the FH– group. Breast conserving treatment is not associated with an increased risk of local recurrence in women with familial breast cancer and the prognosis of these women appears to be similar to that of young women with apparently sporadic breast cancer. However, the risk of contralateral breast cancer is significant in the FH+ group and should be considered in planning primary treatment and follow up.
BRCA1, breast cancer, familial, recurrence, survival
1389-9600
65-72
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
Goddard, Jonathan
5b672b3e-48f1-46c7-8771-1d7b12352365
Coultas, Marie
41bbd443-411f-4e73-b1e5-37851b6b81d4
Hodgson, Shirley
a9f6b2c4-f329-40b5-8b07-a74b3fdd1a0c
Lalloo, Fiona
d7ac29ee-10db-49a5-af3c-265b6d1c113d
Evans, Gareth
ee001bc1-9b29-4a58-a251-a27b18eff669
Haites, Neva
937e85eb-6470-47ff-894d-626a1aa7492a
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
Goddard, Jonathan
5b672b3e-48f1-46c7-8771-1d7b12352365
Coultas, Marie
41bbd443-411f-4e73-b1e5-37851b6b81d4
Hodgson, Shirley
a9f6b2c4-f329-40b5-8b07-a74b3fdd1a0c
Lalloo, Fiona
d7ac29ee-10db-49a5-af3c-265b6d1c113d
Evans, Gareth
ee001bc1-9b29-4a58-a251-a27b18eff669
Haites, Neva
937e85eb-6470-47ff-894d-626a1aa7492a

Eccles, Diana, Simmonds, Peter, Goddard, Jonathan, Coultas, Marie, Hodgson, Shirley, Lalloo, Fiona, Evans, Gareth and Haites, Neva (2001) Familial breast cancer: an investigation into the outcome of treatment for early stage disease. Familial Cancer, 1 (2), 65-72. (doi:10.1023/A:1013867917101).

Record type: Article

Abstract

The purpose of this study was to retrospectively compare the outcomes of treatment in 304 women with familial and sporadic breast cancer to clarify the options for the primary management of familial breast cancer. The majority of women were consecutively ascertained on the basis of either breast cancer diagnosed at age < 40 years or bilateral breast cancer. In addition, known BRCA1 mutation carriers were identified through the genetics services in participating centres. These patients were subdivided into those with a significant family history of breast cancer or known BRCA1 mutation (FH+) and those with no significant family history (FH–). There were no significant differences in age, surgical treatment or adjuvant treatment between the two groups, but there were significantly more women whose nodal status was unknown in the FH+ group. Ipsilateral recurrence occurred in 22.2% of FH+ patients compared with 24.1% of FH– patients (p = 0.774) who underwent breast conserving surgery. There was a striking excess of contralateral breast cancers in the FH+ group (35.9% v 16%, p = 0.0007), with a cumulative risk of contralateral cancer of 36% at 10 years. This was reflected in a non-significant trend toward worse relapse free survival in the FH+ group (p = 0.0563), but no difference was observed in overall survival between the two patient groups (p = 0.142). Similarly, for patients with known BRCA1 mutations, contralateral recurrence occurred more frequently, but other outcomes were not significantly different from the FH– group. Breast conserving treatment is not associated with an increased risk of local recurrence in women with familial breast cancer and the prognosis of these women appears to be similar to that of young women with apparently sporadic breast cancer. However, the risk of contralateral breast cancer is significant in the FH+ group and should be considered in planning primary treatment and follow up.

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More information

Published date: 2001
Keywords: BRCA1, breast cancer, familial, recurrence, survival

Identifiers

Local EPrints ID: 26282
URI: https://eprints.soton.ac.uk/id/eprint/26282
ISSN: 1389-9600
PURE UUID: b3993e72-d45f-4ca5-b37e-5b7084ce4718

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Date deposited: 21 Apr 2006
Last modified: 17 Jul 2017 16:07

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Contributors

Author: Diana Eccles
Author: Peter Simmonds
Author: Jonathan Goddard
Author: Marie Coultas
Author: Shirley Hodgson
Author: Fiona Lalloo
Author: Gareth Evans
Author: Neva Haites

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