Should all BRCA1 mutation carriers with stage I breast cancer receive chemotherapy?
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- 作者：Steven A. Narod (1)
Kelly Metcalfe (1) (2)
Henry T. Lynch (3)
Parviz Ghadirian (4)
Andre Robidoux (4)
Nadine Tung (5)
Elizabeth Gaughan (5)
Charmaine Kim-Sing (6)
Olufunmilayo I. Olopade (7)
William D. Foulkes (8)
Mark Robson (9)
Kenneth Offit (9)
Ania Jakubowska (10)
Tomasz Byrski (10)
Tomasz Huzarski (10)
Ping Sun (1)
Jan Lubinski (10) - 关键词：BRCA1 ; Stage I ; Breast cancer ; Survival
- 刊名：Breast Cancer Research and Treatment
- 出版年：2013
- 出版时间：February 2013
- 年：2013
- 卷：138
- 期：1
- 页码：273-279
- 全文大小：229KB
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15. National Cancer Comprehensive Network (2011) NCNN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network, Inc. ss="a-plus-plus" href="http://www.nccn.org/professionals/physician_gls/f_guidelines.asp">http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed 20 Dec 2012 - 作者单位：Steven A. Narod (1)
Kelly Metcalfe (1) (2)
Henry T. Lynch (3)
Parviz Ghadirian (4)
Andre Robidoux (4)
Nadine Tung (5)
Elizabeth Gaughan (5)
Charmaine Kim-Sing (6)
Olufunmilayo I. Olopade (7)
William D. Foulkes (8)
Mark Robson (9)
Kenneth Offit (9)
Ania Jakubowska (10)
Tomasz Byrski (10)
Tomasz Huzarski (10)
Ping Sun (1)
Jan Lubinski (10)
1. Women’s College Research Institute, 790 Bay Street, Room 750, Toronto, M5G 1N8, Canada
2. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
3. Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA
4. Epidemiology Research Unit, Centre Hospitalier de Université de Montreal (CHUM), Montreal, Canada
5. Beth Israel Deaconess Medical Center, Boston, MA, USA
6. BC Cancer Agency, Vancouver, BC, Canada
7. Department of Medicine, University of Chicago, Chicago, IL, USA
8. Program in Cancer Genetics, McGill University, Montreal, Canada
9. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
10. Pomeranian Medical University, Szczecin, Poland - ISSN：1573-7217
文摘
To estimate the 15-year survival following a diagnosis of stage I breast cancer among women who carry a BRCA1 mutation and to determine predictors of mortality, including the use of chemotherapy. Patients were 379 women with stage I breast cancer for whom a BRCA1 mutation had been identified, in herself or in a close family member. Patients were followed for up to 15?years from the initial diagnosis of breast cancer. Survival rates were estimated for women by age, tumor size (??cm; >1?cm), ER status (±), and by chemotherapy (yes/no). 42 women died of breast cancer in the follow-up period (11.2?%). Survival rates were similar for women with cancers of size 0-.0?cm and size 1.1-.0?cm. Of the 267 women in the study who used chemotherapy, 21 had died (7.9?%) compared to 21 deaths among 112 women who did not receive chemotherapy (18.8?%; p?=?0.002). The 15-year survival was 89.4?% for women who received chemotherapy and was 73.1?% for women who did not receive chemotherapy (p?=?0.08; log rank). The adjusted hazard ratio for death following a diagnosis of stage I breast cancer associated with chemotherapy was 0.53 (95?% CI 0.28-.07; p value 0.06) after adjusting for age of diagnosis, tumor size, and estrogen receptor status. This was statistically significant only among women with ER-negative breast cancers (HR?=?0.28; 95?% CI 0.10-.79; p?=?0.02). BRCA1 positive women who are treated for stage I breast cancer with chemotherapy have better survival than those who do not receive chemotherapy. The difference cannot be explained by other prognostic factors. All women with invasive breast cancer and a BRCA1 mutation should be considered to be candidates for chemotherapy.