Breast Cancer Research and Treatment

, Volume 120, Issue 1, pp 119–126

Is the breast-conserving treatment with radiotherapy appropriate in BRCA1/2 mutation carriers? Long-term results and review of the literature

  • Youlia M. Kirova
  • Alexia Savignoni
  • Brigitte Sigal-Zafrani
  • Anne de La Rochefordiere
  • Rémy J. Salmon
  • Pascale This
  • Bernard Asselain
  • Dominique Stoppa-Lyonnet
  • Alain Fourquet
Clinical Trial

DOI: 10.1007/s10549-009-0685-6

Cite this article as:
Kirova, Y.M., Savignoni, A., Sigal-Zafrani, B. et al. Breast Cancer Res Treat (2010) 120: 119. doi:10.1007/s10549-009-0685-6

Abstract

As tumours in BRCA1/2 mutation carriers might be more sensitive to radiation, we investigated after long-term follow-up whether mutation status influenced the rate of ipsilateral and contralateral breast cancers after breast-conserving treatment (BCT). BRCA1 and BRCA2 genes were screened for germline mutations in 131 patients with a family history of breast and/or ovarian cancer who had undergone BCT and radiotherapy. Patients were matched to 261 controls with sporadic breast cancer according to age at diagnosis and year of treatment. Controls were followed up for at least as long as the interval between diagnosis and genetic screening in familial cases. Rates of ipsilateral and contralateral cancer between groups were compared by the log-rank test. The BRCA1/2 mutations occurred in 20.6% of tested patients. Tumours in mutation carriers were more likely to be grade III (P < 10−4) and oestrogen receptor negative (P = 0.005) than in non-carriers and controls. Overall median follow-up was 161 months. There was no significant difference in ipsilateral tumours between mutation carriers, non-carriers and controls (P = 0.13). On multivariate analysis, age was the most significant predictor for ipsilateral recurrence (P < 10−3). The rate of contralateral cancer was significantly higher in familial cases: 40.7% (mutation carriers), 20% (non-carriers), and 11% (controls) (P < 10−4). After 13.4 years of follow-up, the rate of ipsilateral tumours was no higher in mutation carriers than in non-carriers or controls. As tumours in BRCA1/2 mutation carriers might be more sensitive to radiation, BCT is a possible treatment option.

Keywords

BRCA1/2 mutationsBreast-conserving treatmentRadiotherapyRecurrence

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Youlia M. Kirova
    • 1
  • Alexia Savignoni
    • 2
  • Brigitte Sigal-Zafrani
    • 3
  • Anne de La Rochefordiere
    • 1
  • Rémy J. Salmon
    • 4
  • Pascale This
    • 5
  • Bernard Asselain
    • 2
  • Dominique Stoppa-Lyonnet
    • 5
    • 6
  • Alain Fourquet
    • 1
  1. 1.Department of Radiation OncologyInstitut CurieParis Cedex 05France
  2. 2.Department of BiostatisticsInstitut CurieParis Cedex 05France
  3. 3.Department of PathologyInstitut CurieParis Cedex 05France
  4. 4.Department of SurgeryInstitut CurieParis Cedex 05France
  5. 5.Department of Oncology GeneticsInstitut CurieParis Cedex 05France
  6. 6.University Paris DescartesParisFrance