Survival of BRCA1/BRCA2-associated pT1 breast cancer patients: a cohort study

Barele, M. van; Rieborn, A.; Heemskerk-Gerritsen, B.A.M.; Obdeijn, I.M.; Koppert, L.B.; Loo, C.E.; ... ; Hooning, M.J. (2022)

Article / Letter to editor

Purpose Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement. Methods For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group. Results 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a. Conclusion Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

• BRCA1
• BRCA2
• Tumor size
• Survival
• Breast cancer

• All authors: Barele, M. van; Rieborn, A.; Heemskerk-Gerritsen, B.A.M.; Obdeijn, I.M.; Koppert, L.B.; Loo, C.E.; Tollenaar, R.A.E.M.; Ausems, M.G.E.M.; Beek, I. van de; Berger, L.P.V.; Boer, M. de; Hest, L.P. van; Kets, C.M.; Rookus, M.; Hebon; Schmidt, M.K.; Jager, A.; Hooning, M.J.
• Date: 2022-05-04
• Journal: Breast Cancer Research and Treatment
• Volume: 194
• Issue: 1
• Pages: 159 - 170
• DOI: doi:10.1007/s10549-022-06608-1
• Link: https://link.springer.com/article/10.1007/s10549-022-06608-1