Advertisement

Breast Cancer Research and Treatment

, Volume 168, Issue 2, pp 513–521 | Cite as

Predictors of survival for breast cancer patients with a BRCA1 mutation

  • Steven A. NarodEmail author
  • Tomasz Huzarski
  • Jacek Gronwald
  • Tomasz Byrski
  • Elzbieta Marczyk
  • Cezary Cybulski
  • Marek Szwiec
  • Rafal Wisniowski
  • Bozena Birkenfeld
  • Ewa Kilar
  • Robert Sibilski
  • Ping Sun
  • Jan Lubinski
Epidemiology

Abstract

Purpose

To evaluate in a contemporary cohort the impacts of chemotherapy and oophorectomy on survival for breast cancer patients with a BRCA1 mutation.

Experimental design

We reviewed the pathology reports and medical records of 372 women with breast cancer and a BRCA1 mutation, diagnosed from 2005 to 2017, between the ages of 25 and 65 and followed them for death from all causes and death from breast cancer. Death was ascertained through the Poland vital statistics registry. We performed survival analysis to evaluate the impacts of chemotherapy (including neoadjuvant cisplatinum) and of oophorectomy on survival.

Results

After a mean follow-up of 5.6 years (median 5.2), 66 of the 372 women died; 56 of the deaths were from breast cancer and 6 were from ovarian cancer. 127 women received neoadjuvant cisplatinum and 245 women received other chemotherapies. Cisplatinum (versus all other therapies) was associated with a hazard ratio of 0.42 (95%CI 0.20–0.87) on breast cancer-specific survival. The 10-year actuarial all-cause survival for women who had both cisplatinum and an oophorectomy was 94.4%. The 10-year all-cause survival for women who had neither cisplatinum nor an oophorectomy was 65.4% (p < 0.01).

Conclusions

Cisplatinum and oophorectomy are effective therapies for women with breast cancer and a BRCA1 mutation.

Keywords

BRCA1 Breast cancer Survival Cisplatinum Oophorectomy 

Notes

Acknowledgements

We thank Ewa Putresza for excellent technical support. We thank the Peter Gilgan Foundation Tour de Bleu and Estée Lauder Companies for their generous support of this project.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Jonasson JG, Stefansson OA, Johannsson OT, Sigurdsson H, Agnarsson BA, Olafsdottir GH, Alexiusdottir KK, Stefansdottir H, Munoz Mitev R, Olafsdottir K, Olafsdottir K, Arason A, Stefansdottir V, Olafsdottir EJ, Barkardottir RB, Eyfjord JE, Narod SA, Tryggvadóttir L (2016) Oestrogen receptor status, treatment and breast cancer prognosis in Icelandic BRCA2 mutation carriers. Br J Cancer 115(7):776–783CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Cybulski C, Kluźniak W, Huzarski T, Wokołorczyk D, Kashyap A, Jakubowska A, Szwiec M, Byrski T, Dębniak T, Górski B, Sopik V, Akbari MR, Sun P, Gronwald J, Narod SA (2015) Lubiński J; Polish Hereditary Breast Cancer Consortium. Clinical outcomes in women with breast cancer and a PALB2 mutation: a prospective cohort analysis. Lancet Oncol 16(6):638–644CrossRefPubMedGoogle Scholar
  3. 3.
    Marcus JN, Watson P, Page DL, Narod SA, Tonin P, Lenoir GM, Serova O, Lynch HT (1997) BRCA2 hereditary breast cancer pathophenotype. Breast Cancer Res Treat 44:275–277CrossRefPubMedGoogle Scholar
  4. 4.
    Lakhani SR, Jacquemier J, Sloane JP, Gusterson BA, Anderson TJ, van de Vijver MJ, Farid LM, Venter D, Antoniou A, Storger-Isser A, Smyth E, Steel CM, Haites N, Scott RJ, Goldgar D, Neuhausen S, Daly PA, Ormiston W, McManus R, Scherneck S, Ponder BA, Ford D, Peto J, Stoppa-Lyonnet D, Bignon YJ, Struewing JP, Spurr NK, Bishop DT, Klijn JG, Devilee P et al (1998) Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst 90:1138–1145CrossRefPubMedGoogle Scholar
  5. 5.
    Narod SA, Metcalfe K, Lynch HT, Ghadirian P, Robidoux A, Tung N, Gaughan E, Kim-Sing C, Olopade OI, Foulkes WD, Robson M, Offit K, Jakubowska A, Byrski T, Huzarski T, Sun P, Lubinski J (2013) Should all BRCA1 mutation carriers with stage I breast cancer receive chemotherapy? Breast Cancer Res Treat 138(1):273–279CrossRefPubMedGoogle Scholar
  6. 6.
    Byrski T, Huzarski T, Dent R, Marczyk E, Jasiowka M, Gronwald J, Jakubowicz J, Cybulski C, Wisniowski R, Godlewski D, Lubinski J, Narod SA (2014) Pathologic complete response to neoadjuvant cisplatin in BRCA1-positive breast cancer patients. Breast Cancer Res Treat 147(2):401–405CrossRefPubMedGoogle Scholar
  7. 7.
    Arun B, Bayraktar S, Liu DD, Gutierrez Barrera AM, Atchley D, Pusztai L, Litton JK, Valero V, Meric-Bernstam F, Hortobagyi GN, Albarracin C (2011) Response to neoadjuvant systemic therapy for breast cancer in BRCA mutation carriers and noncarriers: a single-institution experience. J Clin Oncol 29(28):3739–3746CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Finch AP, Lubinski J, Møller P, Singer CF, Karlan B, Senter L, Rosen B, Maehle L, Ghadirian P, Cybulski C, Huzarski T, Eisen A, Foulkes WD, Kim-Sing C, Ainsworth P, Tung N, Lynch HT, Neuhausen S, Metcalfe KA, Thompson I, Murphy J, Sun P, Narod SA (2014) Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. J Clin Oncol 32(15):1547–1553CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Metcalfe K, Lynch HT, Foulkes WD, Tung N, Kim-Sing C, Olopade OI, Eisen A, Rosen B, Snyder C, Gershman S, Sun P, Narod SA (2015) Effect of oophorectomy on survival after breast cancer in BRCA1 and BRCA2 mutation carriers. JAMA Oncol. 1(3):306–313CrossRefPubMedGoogle Scholar
  10. 10.
    Huzarski T, Byrski T, Gronwald J, Cybulski C, Oszurek O, Szwiec M, Gugała K, Stawicka M, Morawiec Z, Mierzwa T, Falco M, Janiszewska H, Kilar E, Marczyk E, Kozak-Klonowska B, Siołek M, Surdyka D, Wiśniowski R, Posmyk M, Domagała P, Sun P, Lubiński J (2016) Narod SA; Polish Breast Cancer Consortium. The impact of oophorectomy on survival after breast cancer in BRCA1-positive breast cancer patients. Breast Cancer Res Treat 156(2):371–378CrossRefPubMedGoogle Scholar
  11. 11.
    Robson M, Im SA, Senkus E, Xu B, Domchek SM, Masuda N, Delaloge S, Li W, Tung N, Armstrong A, Wu W, Goessl C, Runswick S, Conte P (2017) Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation. N Engl J Med 377(6):523–533CrossRefPubMedGoogle Scholar
  12. 12.
    Górski B, Byrski T, Huzarski T, Jakubowska A, Menkiszak J, Gronwald J, Pluzanski A, Bebenek M, Fischer-Maliszewska L, Grzybowska E, Narod SA, Lubinski J (2000) Founder mutations in BRCA1 gene in Polish families with breast-ovarian cancer. Am J Hum Genet 66:1963–1968CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Long Roche KC, Abu-Rustum NR, Nourmoussavi M, Zivanovic O (2017) Risk-reducing salpingectomy: let us be opportunistic. Cancer 123(10):1714–1720CrossRefPubMedGoogle Scholar
  14. 14.
    Labidi-Galy SI, Papp E, Hallberg D, Niknafs N, Adleff V, Noe M, Bhattacharya R, Novak M, Jones S, Phallen J, Hruban CA, Hirsch MS, Lin DI, Schwartz L, Maire CL, Tille JC, Bowden M, Ayhan A, Wood LD, Scharpf RB, Kurman R, Wang TL, Shih IM, Karchin R, Drapkin R, Velculescu VE (2017) High grade serous ovarian carcinomas originate in the fallopian tube. Nat Commun 8(1):1093CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Heemskerk-Gerritsen BA, Seynaeve C, van Asperen CJ, Ausems MG, Collée JM, van Doorn HC, Gomez Garcia EB, Kets CM, van Leeuwen FE, Meijers-Heijboer HE, Mourits MJ, van Os TA, Vasen HF, Verhoef S, Rookus MA, Hooning MJ; Hereditary Breast and Ovarian Cancer Research Group Netherlands (2015) Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J Natl Cancer Inst.  https://doi.org/10.1093/jnci/djv033 Google Scholar
  16. 16.
    Kotsopoulos J, Huzarski T, Gronwald J, Singer CF, Moller P, Lynch HT, Armel S, Karlan B, Foulkes WD, Neuhausen SL, Senter L, Tung N, Weitzel JN, Eisen A, Metcalfe K, Eng C, Pal T, Evans G, Sun P, Lubinski J, Narod SA, Hereditary Breast Cancer Clinical Study Group (2016) Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 Mutation Carriers. J Natl Cancer.  https://doi.org/10.1093/jnci/djw177 Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Steven A. Narod
    • 1
    Email author
  • Tomasz Huzarski
    • 2
  • Jacek Gronwald
    • 2
  • Tomasz Byrski
    • 2
  • Elzbieta Marczyk
    • 3
  • Cezary Cybulski
    • 2
  • Marek Szwiec
    • 4
  • Rafal Wisniowski
    • 5
  • Bozena Birkenfeld
    • 6
  • Ewa Kilar
    • 7
  • Robert Sibilski
    • 8
  • Ping Sun
    • 1
  • Jan Lubinski
    • 2
  1. 1.Women’s College Research InstituteUniversity of TorontoTorontoCanada
  2. 2.International Hereditary Cancer Center, Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
  3. 3.Marie Sklodowska ClinicCurie Memorial InstituteKrakowPoland
  4. 4.Department of Clinical OncologyTadeusz Koszarowski Regional Oncology CenterOpolePoland
  5. 5.Department of Clinical OncologyRegional Oncology CenterBielsko-BialaPoland
  6. 6.Department of Molecular MedicinePomeranian Medical UniversitySzczecinPoland
  7. 7.Counselling UnitRegional Oncology CenterŚwidnicaPoland
  8. 8.Oncology Diagnostic CenterZielona GóraPoland

Personalised recommendations