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Outcome of metastatic breast cancer in selected women with or without deleterious BRCA mutations

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Abstract

The aim of this study was to compare the time-to progression and overall survival (OS) in patients with metastatic breast cancer (MBC) with and without deleterious BRCA1/2 mutations. 195 women with MBC who were referred for BRCA genetic testing between 1997 and 2011 were included in the study. Logistic regression models and Cox proportional hazards models were fit to determine the associations between clinical variables and outcomes. Of 195 women with MBC, 21 % (n = 41) were positive for BRCA1/2 mutations. The number of metastatic sites at the time of metastatic disease was not different between BRCA1 versus BRCA2 carriers versus non-carriers (P = 0.77). The site of first metastasis was visceral-only in 70 % of BRCA1 carriers compared to 9 % in BRCA2 carriers and 37 % in non-carriers (P = 0.001). Median follow-up was 2.8 years. BRCA non-carriers and BRCA2 carriers had a longer time-to progression and OS compared to BRCA1 carriers (median time-to progression = 1.3 vs. 0.9 vs. 0.7 years; P = 0.31, and median OS = 4.88 vs. 4.94 vs. 1.34 years; P = 0.0065). In a multivariate model, no association was identified between BRCA positivity and time-to-event outcomes (P > 0.28). In addition, patients with triple-negative MBC carried a poorer prognosis irrespective of their BRCA status (P = 0.058 and P = 0.15 for the interaction term of BRCA status and triple-negative for time-to progression and OS, respectively). Our data indicate that BRCA1 carriers diagnosed with MBC have worse outcomes compared to BRCA2 carriers and non-carriers. However, the differences in outcome did not reach statistical significance likely due to small sample sizes.

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Acknowledgments

This work was supported by the Lynne Cohen Breast and Ovarian Cancer Project; Texas Business Women Funding; and the Nellie B. Connally Breast Cancer Research Fund, and the MD Anderson Cancer Center Support Grant 2P30 CA016672.

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Authors have no conflict interest to declare.

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Authors and Affiliations

  1. Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    S. Bayraktar & T. Tasbas

  2. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030-4009, USA

    S. Bayraktar, A. M. Gutierrez-Barrera, N. Elsayegh, T. Tasbas, J. K. Litton, N. K. Ibrahim, P. K. Morrow, M. Green, V. Valero, D. J. Booser, G. N. Hortobagyi & B. K. Arun

  3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    H. Lin & T. Tasbas

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  1. S. Bayraktar
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Bayraktar, S., Gutierrez-Barrera, A.M., Lin, H. et al. Outcome of metastatic breast cancer in selected women with or without deleterious BRCA mutations. Clin Exp Metastasis 30, 631–642 (2013). https://doi.org/10.1007/s10585-013-9567-8

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