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Impact of multifocal or multicentric disease on local recurrence and survival in breast cancer patients with or without BRCA1/2 variants

  • Preclinical study
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Abstract

Purpose

Multifocal or multicentric (MFMC) breast cancer is mainly focused on breast cancer patients with unknown BRCA status, the incidence and clinical relevance of MFMC disease in BRCA1/2 carriers is less explored to date. Our study was to investigate the incidence of MFMC disease in BRCA1/2 carriers and whether MFMC disease influences local recurrence and clinical outcomes.

Methods

In this retrospective study, 479 breast cancer patients with BRCA1/2 variants and 1437 age-matched noncarriers were enrolled and patients received either breast-conserving therapy (BCT) or mastectomy with or without radiotherapy.

Results

The rates of MFMC disease in BRCA1 and BRCA2 carriers, and noncarriers were 33.0% (61 of 185), 37.4% (110 of 294), and 31.2% (449 of 1437), respectively. MFMC disease in BRCA2 carriers was significantly higher than that in noncarriers (P = 0.039). After a median follow-up of 8.1 years, among patients treated with BCT, BRCA2 carriers with MFMC disease experienced a significantly higher rate of ipsilateral breast tumor recurrence (IBTR) than those with unifocal disease (16.7% vs 4.1%, P = 0.044). Moreover, BRCA2 carriers with MFMC disease had a significantly worse RFS (unadjusted hazard ratio [HR], 3.65 [95% CI 1.40–9.52]; P = 0.008), DRFS (unadjusted HR, 3.07 [95% CI 1.07–8.80]; P = 0.037), and OS (unadjusted HR, 4.96 [95% CI 1.18–20.02]; P = 0.029) than those with unifocal disease when treated with BCT.

Conclusion

MFMC breast cancer is more common in BRCA2 carriers, and BRCA2 carriers with MFMC disease treated with BCT exhibit a higher rate of IBTR and may have a poor survival.

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Data availability

All data and material relevant to the study are available from the corresponding author upon reasonable request.

Abbreviations

BCT:

Breast-conserving therapy

BI-RADS:

Breast imaging-reporting and data system

DRFS:

Distant recurrence-free survival

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor-2

HR:

Hazard ratio

IBTR:

Ipsilateral breast tumor recurrence

MFMC:

Multifocal or multicentric

MRI:

Magnetic resonance imaging

OS:

Overall survival

PR:

Progesterone receptor

RT:

Radiotherapy

RFS:

Recurrence-free survival

TNBC:

Triple-negative breast cancer

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Funding

This work was supported by National Natural Science Foundation of China (Nos. 81974422, 81772824, 81672625) and Beijing Municipal Administration of Hospitals Incubating Program (No. PX2021042).

Author information

Author notes

  1. Xuejing Liu, Yanjie Wang, Kun Cao, Lu Yao have contributed equally to this study.

Authors and Affiliations

  1. Familial & Hereditary Cancer Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Xuejing Liu, Lu Yao, Li Hu, Jie Sun, Juan Zhang, Ye Xu & Yuntao Xie

  2. Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Yanjie Wang

  3. Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Kun Cao

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by XL, YW, KC, LY, LH, JS, JZ, YX and YX. The first draft of the manuscript was written by XL, YW, KC, LY and YX and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yuntao Xie.

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Liu, X., Wang, Y., Cao, K. et al. Impact of multifocal or multicentric disease on local recurrence and survival in breast cancer patients with or without BRCA1/2 variants. Breast Cancer Res Treat 199, 25–33 (2023). https://doi.org/10.1007/s10549-023-06904-4

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  • DOI: https://doi.org/10.1007/s10549-023-06904-4

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