Bibliographic Details
| Title: |
Effects of chemotherapy on contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers: A nationwide cohort study |
| Authors: |
Delal Akdeniz, Mark van Barele, Bernadette A.M. Heemskerk-Gerritsen, Ewout W. Steyerberg, Michael Hauptmann, Irma van de Beek, Klaartje van Engelen, Marijke R. Wevers, Encarnacion B. Gómez García, Margreet G.E.M. Ausems, Lieke P.V. Berger, Christi J. van Asperen, Muriel A. Adank, Margriet J. Collée, Denise J. Stommel-Jenner, Agnes Jager, Marjanka K. Schmidt, Maartje J. Hooning |
| Source: |
Breast, Vol 61, Iss , Pp 98-107 (2022) |
| Publisher Information: |
Elsevier, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: |
Breast cancer, Secondary, Risk factors, Chemotherapy, BRCA1, BRCA2, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: |
Aim: BRCA1/2 mutation carriers with primary breast cancer (PBC) are at high risk of contralateral breast cancer (CBC). In a nationwide cohort, we investigated the effects of chemotherapeutic agents given for PBC on CBC risk separately in BRCA1 and BRCA2 mutation carriers. Patients and methods: BRCA1 or BRCA2 mutation carriers with an invasive PBC diagnosis from 1990 to 2017 were selected from a Dutch cohort. We estimated cumulative CBC incidence using competing risks analysis. Hazard ratios (HR) for the effect of neo-adjuvant or adjuvant chemotherapy and different chemotherapeutic agents on CBC risk were estimated using Cox regression. Results: We included 1090 BRCA1 and 568 BRCA2 mutation carriers; median follow-up was 8.9 and 8.4 years, respectively. Ten-year cumulative CBC incidence for treatment with and without chemotherapy was 6.7% [95%CI: 5.1–8.6] and 16.7% [95%CI: 10.8–23.7] in BRCA1 and 4.8% [95%CI: 2.7–7.8] and 16.0% [95%CI: 9.3–24.4] in BRCA2 mutation carriers, respectively. Chemotherapy was associated with reduced CBC risk in BRCA1 (multivariable HR: 0.46, 95%CI: 0.29–0.74); a similar trend was observed in BRCA2 mutation carriers (HR: 0.63, 95%CI: 0.29–1.39). In BRCA1, risk reduction was most pronounced in the first 5 years (HR: 0.32, 95%CI: 0.17–0.61). Anthracyclines and the combination of anthracyclines with taxanes were associated with substantial CBC risk reduction in BRCA1 carriers (HR: 0.34, 95%CI: 0.17–0.68 and HR: 0.22, 95%CI: 0.08–0.62, respectively). Conclusion: Risk-reducing effects of chemotherapy are substantial for at least 5 years and may be used in personalised CBC risk prediction in any case for BRCA1 mutation carriers. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1532-3080 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S0960977621010134; https://doaj.org/toc/1532-3080 |
| DOI: |
10.1016/j.breast.2021.12.007 |
| Access URL: |
https://doaj.org/article/f07b5cdd82d14cf6b8c51743fa5578cb |
| Accession Number: |
edsdoj.f07b5cdd82d14cf6b8c51743fa5578cb |
| Database: |
Directory of Open Access Journals |
