Breast-Conserving Therapy in Women with BRCA1/BRCA2-Associated Breast Cancer
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In this article, the controversial issue of breast-conserving therapy (i.e., lumpectomy followed by whole breast irradiation) is reviewed. Given the relatively recent identification of the BRCA1 and BRCA2 genes in the mid-1990s, the expense associated with testing, and the inherent selection biases, the available literature has inherent limitations with relatively small patient numbers and lack of prospective randomized trials in this subset of patients. However, a number of retrospective and case-control studies have demonstrated acceptable results with breast-conserving surgery and radiation, although without active prophylactic measures to reduce secondary malignancies, late local in-breast relapses and contralateral secondary breast cancer events remain an issue. Acknowledging the limitations in the available data, there does not appear to be any evidence of compromised normal tissue reactions or compromised long-term survival rates in women electing breast-conserving surgery and radiation.
- Fisher B, Anderson S: Conservative surgery for the management of invasive and noninvasive carcinoma of the breast: NSABP trials. National Surgical Adjuvant Breast and Bowel Project. World J Surg 1994, 18:63–69. CrossRef
- Fisher B, Anderson S, Bryant J, et al.: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002, 347:1233–1241. CrossRef
- Mock V: Body image in women treated for breast cancer. Nurs Res 1993, 42:153–157. CrossRef
- Schain WS, d’Angelo TM, Dunn ME, et al.: Mastectomy versus conservative surgery and radiation therapy. Psychosocial consequences. Cancer 1994, 73:1221–1228. CrossRef
- Struewing JP, Abeliovich D, Peretz T, et al.: The carrier frequency of the BRCA1 185delAG mutation is approximately 1 percent in Ashkenazi Jewish individuals. Nat Genet 1995, 11:198–200. CrossRef
- FitzGerald MG, MacDonald DJ, Krainer M, et al.: Germ-line BRCA1 mutations in Jewish and non-Jewish women with early-onset breast cancer. N Engl J Med 1996, 334:143–149. CrossRef
- Venkitaraman A: Cancer susceptibility and the functions of BRCA1 and BRCA2. Cell 2002, 108:171. CrossRef
- Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Natl Cancer Inst 1999, 91:1310–1316.
- Ansquer Y, Gautier C, Fourquet A, et al.: Survival in early-onset BRCA1 breast-cancer patients. Institut Curie Breast Cancer Group. Lancet 1998, 352:541. CrossRef
- Robson ME, Boyd J, Borgen PI, et al.: Hereditary breast cancer. Curr Probl Surg 2001, 38:387–480. CrossRef
- Robson ME, Chappuis PO, Satagopan J, et al.: A combined analysis of outcome following breast cancer: differences in survival based on BRCA1/BRCA2 mutation status and administration of adjuvant treatment. Breast Cancer Res 2004, 6:R8–R17. CrossRef
- Seynaeve C, Verhoog LC, Van De Bosch LM, et al.: Ipsilateral breast tumour recurrence in hereditary breast cancer following breast-conserving therapy. Eur J Cancer 2004, 40:1150–1158. CrossRef
- Prevalence and penetrance of BRCA1 and BRCA2 mutations in a population-based series of breast cancer cases. Anglian Breast Cancer Study Group. Br J Cancer 2000, 83:1301–1308.
- Brekelmans CT, Tilanus-Linthorst MM, Seynaeve C, et al.: Tumour characteristics, survival and prognostic factors of hereditary breast cancer from BRCA2-, BRCA1- and non-BRCA1/2 families as compared to sporadic breast cancer cases. Eur J Cancer 2007, 43:867–876. CrossRef
- Rennert G, Bisland-Naggan S, Barnett-Griness O, et al.: Clinical outcomes of breast cancer in carriers of BRCA1 and BRCA2 mutations. N Engl J Med 2007, 357:115–123. CrossRef
- Metcalfe KA, Finch A, Poll A, et al.: Breast cancer risks in women with a family history of breast or ovarian cancer who have tested negative for a BRCA1 or BRCA2 mutation. Br J Cancer 2009, 100:421–425. CrossRef
- Rebbeck TR, Friebel T, Lynch HT, et al.: Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol 2004, 22:1055–1062. CrossRef
- Brandburg Y, Sandelin K, Erikson S, et al.: Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high-risk for breast cancer: a prospective 1-year follow-up study. J Clin Oncol 2008, 26:3943–3949. CrossRef
- Haffty BG, Harrold E, Khan AJ, et al.: Outcome of conservatively managed early-onset breast cancer by BRCA1/2 status. Lancet 2002, 359:1471–1477. CrossRef
- Steinmann D, Bremer M, Rades D, et al.: Mutations of the BRCA1 and BRCA2 genes in patients with bilateral breast cancer. Br J Cancer 2001, 85:850–858. CrossRef
- Pierce LJ, Levin AM, Rebbeck TR, et al.: Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1/2-associated stage I/II breast cancer. J Clin Oncol 2006, 24:2437–2443. CrossRef
- Robson M, Levin D, Federici M, et al.: Breast conservation therapy for invasive breast cancer in Ashkenazi women with BRCA gene founder mutations. J Natl Cancer Inst 1999, 91:2112–2117. CrossRef
- Robson M, Svahn T, McCormick B, et al.: Appropriateness of breast-conserving treatment of breast carcinoma in women with germline mutations in BRCA1 or BRCA2: a clinic-based series. Cancer 2005, 103:44–51. CrossRef
- Kirova YM, Stoppa-Lyonnet D, Savignoni A, et al.: Risk of breast cancer recurrence and contralateral breast cancer in relation to BRCA1 and BRCA2 mutation status following breast-conserving surgery and radiotherapy. Eur J Cancer 2005, 41:2304–2311. CrossRef
- Pierce L, Griffith K, Buys S, et al.: Outcomes following breast conservation versus mastectomy in BRCA1/2 carriers with early-stage breast cancer. J Clin Oncol 2008, 26:Abstract 536.
- Smith BD, Arthur DW, Buchholz TA, et al.: Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys 2009, 74:987–1001.
- Pierce LJ, Strawderman M, Narod SA, et al.: Effect of radiotherapy after breast-conserving treatment in women with breast cancer and germline BRCA1/2 mutations. J Clin Oncol 2000, 18:3360–3369.
- Narod SA, Brunet JS, Ghadirian P, et al.: Tamoxifen and risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers: a case-control study. Hereditary Breast Cancer Clinical Study Group. Lancet 2000, 356:1876–1881. CrossRef
- Rebbeck TR: Prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 2000, 18:100S–103S.
- Breast-Conserving Therapy in Women with BRCA1/BRCA2-Associated Breast Cancer
Current Breast Cancer Reports
Volume 2, Issue 2 , pp 90-95
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