Journal article
Adjuvant systemic therapy for breast cancer in BRCA1/BRCA2 mutation carriers in a population-based study of risk of contralateral breast cancer
Breast cancer research and treatment, Vol.123(2), pp.491-498
09/2010
DOI: 10.1007/s10549-010-0769-3
PMCID: PMC2903659
PMID: 20135344
Abstract
Given the greatly elevated risks of contralateral breast cancer (CBC) observed in breast cancer patients who carry mutations in BRCA1 and BRCA2, it is critical to determine the effectiveness of standard adjuvant therapies in preventing CBC in mutation carriers. The WECARE study is a matched, case-control study of 708 women with CBC as cases and 1,399 women with unilateral breast cancer (UBC) as controls, including 181 BRCA1/BRCA2 mutation carriers. Interviews and medical record reviews provided detailed information on risk factors and breast cancer therapy. All study participants were screened for BRCA1 and BRCA2 mutations using denaturing high-performance liquid chromatography (DHPLC) to detect genetic variants in the coding and flanking regions of the genes. Conditional logistic regression was used to compare the risk of CBC associated with chemotherapy and tamoxifen in BRCA1/BRCA2 mutation carriers and non-carriers. Chemotherapy was associated with lower CBC risk both in non-carriers (RR = 0.6 [95% CI: 0.5-0.7]) and carriers (RR = 0.5 [95% CI: 0.2-1.0]; P value = 0.04). Tamoxifen was associated with a reduced CBC risk in non-carriers (RR = 0.7 [95% CI: 0.6-1.0]; P value = 0.03). We observed a similar but non-significant reduction associated with tamoxifen in mutation carriers (RR = 0.7 [95% CI: 0.3-1.8]). The tests of heterogeneity comparing carriers to non-carriers did not provide evidence for a difference in the associations with chemotherapy (P value = 0.51) nor with tamoxifen (P value = 0.15). Overall, we did not observe a difference in the relative risk reduction associated with adjuvant treatment between BRCA1/BRCA2 mutation carriers and non-carriers. However, given the higher absolute CBC risk in mutation carriers, the potentially greater impact of adjuvant therapy in reducing CBC risk among mutation carriers should be considered when developing treatment plans for these patients.
Details
- Title: Subtitle
- Adjuvant systemic therapy for breast cancer in BRCA1/BRCA2 mutation carriers in a population-based study of risk of contralateral breast cancer
- Creators
- Kerryn W Reding - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Mail Stop M4-B874, Seattle, WA 98109-1024, USA. kreding@u.washington.eduJonine L BernsteinBryan M LangholzLeslie BernsteinRobert W HaileColin B BeggCharles F LynchPatrick ConcannonAke BorgSharon N TeraokaTherese TörngrenAnh DiepShanyan Xue - University of Southern CaliforniaLisbeth BertelsenXiaolin LiangAnne S ReinerMarinela CapanuKathleen E MaloneWECARE Collaborative Study Group
- Resource Type
- Journal article
- Publication Details
- Breast cancer research and treatment, Vol.123(2), pp.491-498
- DOI
- 10.1007/s10549-010-0769-3
- PMID
- 20135344
- PMCID
- PMC2903659
- NLM abbreviation
- Breast Cancer Res Treat
- ISSN
- 1573-7217
- eISSN
- 1573-7217
- Publisher
- Netherlands
- Grant note
- 2 T32 CA 09168 / NCI NIH HHS R01 CA129639 / NCI NIH HHS U01 CA083178 / NCI NIH HHS R01 AG014358 / NIA NIH HHS U01 CA083178-06 / NCI NIH HHS R01CA097397 / NCI NIH HHS R01 CA097397 / NCI NIH HHS R01 CA097397-04 / NCI NIH HHS U01CA083178 / NCI NIH HHS T32 CA009168 / NCI NIH HHS T32 CA009168-30 / NCI NIH HHS
- Language
- English
- Date published
- 09/2010
- Academic Unit
- Epidemiology
- Record Identifier
- 9983996083502771
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