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Prognosis of early-onset breast cancer based on BRCA1/2 mutation status in a French population-based cohort and review

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Abstract

Purpose

The debate concerning poorer survival for patients with breast cancer (BC) carrying a BRCA1 germline mutation is unresolved, and requires additional data from population-based studies.

Patients and methods

We followed 232 women with invasive BC under age 46, ascertained prospectively through a French population-based BC registry and tested for BRCA1/2 mutations (median follow-up: 82 months). We compared tumour characteristics and survival rates between 21 BRCA1/2 deleterious mutation carriers and 211 non-carriers.

Results

As compared to sporadic tumours, BRCA1/2 tumours showed higher grade (P = 0.02), fewer ductal carcinoma in situ (P = 0.02), more frequent medullary histology (P = 0.02), more frequent negative oestrogen and progesterone receptors (P = 0.001 each). At 5 years, BC-specific survival, metastasis-free survival, ipsilateral recurrence-free survival and contralateral BC-free survival rates for BRCA1/2 mutation carriers were 95.0%, 94.7%, 100% and 90.0% respectively, compared with 89.6%, 78.2%, 88.8% and 94.4% respectively, for non-carriers (not significant). Rates for women carrying only a BRCA1 mutation were 93.3%, 93.3%, 100%, 86.7%, respectively. 76% of BRCA1/2 carriers received chemotherapy.

Conclusion

Despite unfavourable tumour features, we found no evidence for poorer short-term survival in BRCA1 mutation carriers compared to non-carriers in this prospective population-based cohort. The high rate of BRCA1 carriers who received chemotherapy for their BC should question the positive impact of this treatment, as suggested by preclinical studies showing increased chemosensitivity of BRCA1-associated tumours.

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Acknowledgements

This study was supported by grants from the « Fondation de France », the « Comité départemental du Rhône de la Ligue Contre le Cancer » and the « Fédération Nationale des Groupements des Entreprises Françaises dans la lutte contre le cancer ».

We thank Cécile Giraud for collecting follow-up data and Sandrine Handallou for technical assistance.

We thank Margaret Haugh for her help with the preparation of this manuscript.

We thank the investigators participating in this study: Ardiet JM, Ardisson P, Audra P, Aussavis F, Barbier B, Barrier PY, Berard P, Berland M, Berlier JL, Dargent D, Bernard M, Blondet R, Bobin JY, Bolsigner L, Bonardel C, Bonnevie R, Boue P, Boulet S, Bouzid D, Bremond A, Broussard, Buatois F, Canat EP, Carrie C, Catimel G, Cauvin I, Chabert, Champion F, Chassagnard F, Chauvot P, Cognat M, Coquard R, Coste JD, Courtieu G, Cousin C, Crozet B, De Roissard, De saint Hilaire P, Dumas AM, Gaucherand P, Gelas M, Gerard JP, Gillion, Golfier F, Goncalves M, Gratadour AC, Guastalla JP, Ingels J, Jacquot D, Jaussaud D, Labrosse H, Lafont A, Lagoutte J, Lambert J, Laville, Le Maout G, Mallecourt P, Marsaud H, Martin A, Martin JP, Martin P, Mathevet P, Mayer B, Mellier G, Mignotte H, Montvernay C, Palayer C, Papillon M, Pasquier J, Pegaz M, Piacenza JM, Pic JC, Raudrant D, Raymaud, Romestaing P, Rondelet O, Rudigoz RC, Salles B, Seligmann G, Servajean F, Tairraz JP, Thevenot-Rivoire D, Thome Saint Paul M, Victoria J, Vidal M, Villard, Watrelot A, Zinzindouhe C, Zlatoff␣P.

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Authors and Affiliations

  1. Centre Léon Bérard, Unit of Prevention and Genetic Epidemiology, 28 rue Laënnec, 69 373, Lyon cedex 08, France

    Valérie Bonadona, Sophie Dussart-Moser, Nicolas Voirin & Christine Lasset

  2. International Agency for Research on Cancer, Lyon, France

    Olga M Sinilnikova

  3. Plate-forme mixte de génétique constitutionnelle des cancers fréquents, Hospices Civils de Lyon/Centre Léon Bérard, Lyon, France

    Olga M Sinilnikova

  4. Department of Surgical Oncology, Centre Léon Bérard, Lyon, France

    Hervé Mignotte & Alain Brémond

  5. Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

    Patrice Mathevet

  6. ADEMAS, Breast Cancer Rhône Registry, Lyon, France

    Alain Brémond

  7. Department of Pathology, Centre Léon Bérard, Lyon, France

    Isabelle Treilleux

  8. Clinique Jeanne d’Arc, Lyon, France

    Alain Martin

  9. Department of Radiotherapy and Oncology, Lyon-Sud Hospital Center, Hospices Civils de Lyon, Pierre-Benite, France

    Pascale Romestaing

  10. Hôtel Dieu Hospital, Hospices Civils de Lyon, Lyon, France

    Daniel Raudrant

  11. Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France

    René-Charles Rudigoz

  12. CNRS - UMR 8125, Institut Gustave Roussy, Villejuif, France

    Gilbert M. Lenoir

  13. Laboratoire d’Epidémiologie et de Santé Publique, Université Claude Bernard Lyon I, Lyon, France

    Christine Lasset

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  1. Valérie Bonadona
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  2. Sophie Dussart-Moser
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  3. Nicolas Voirin
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  4. Olga M Sinilnikova
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  7. Alain Brémond
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  8. Isabelle Treilleux
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  9. Alain Martin
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  11. Daniel Raudrant
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  12. René-Charles Rudigoz
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  13. Gilbert M. Lenoir
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  14. Christine Lasset
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Correspondence to Valérie Bonadona.

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Bonadona, V., Dussart-Moser, S., Voirin, N. et al. Prognosis of early-onset breast cancer based on BRCA1/2 mutation status in a French population-based cohort and review. Breast Cancer Res Treat 101, 233–245 (2007). https://doi.org/10.1007/s10549-006-9288-7

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  • DOI: https://doi.org/10.1007/s10549-006-9288-7

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