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

Mark van Barele, Amy Rieborn, Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Bernadette A.M. Heemskerk-Gerritsen, Inge Marie Obdeijn, Linetta B. Koppert, Claudette E. Loo, Rob A.E.M. Tollenaar, Margreet G.E.M. Ausems, Irma van de Beek, Lieke P.V. Berger, Maaike de Boer, Liselot P. van Hest, C. Marleen Kets, Matti Rookus, Marjanka K. Schmidt, Agnes Jager, Maartje J. Hooning*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

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.

Original languageEnglish
Pages (from-to)159-170
Number of pages12
JournalBreast Cancer Research and Treatment
Volume194
Issue number1
Early online date4 May 2022
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON) consists of the following Collaborating Centers: Netherlands Cancer Institute (coordinating center), Amsterdam, NL: M.A. Rookus, F.B.L. Hogervorst, F.E. van Leeuwen, M.A. Adank, M.K. Schmidt, D.J. Stommel-Jenner, R. de Groot; Erasmus Medical Center, Rotterdam, NL: J.M. Collée, A.M.W. van den Ouweland, M.J. Hooning, I.A. Boere; Leiden University Medical Center, NL: C.J. van Asperen, P. Devilee, R.B. van der Luijt, T.C.T.E.F. van Cronenburg; Radboud University Nijmegen Medical Center, NL: M.R. Wevers, A.R. Mensenkamp; University Medical Center Utrecht, NL: M.G.E.M. Ausems, M.J. Koudijs; Amsterdam UMC, Univ of Amsterdam, NL: I. van de Beek; Amsterdam UMC, Vrije Universiteit Amsterdam, NL: K. van Engelen, J.J.P. Gille; Maastricht University Medical Center, NL: E.B. Gómez García, M.J. Blok, M. de Boer; University of Groningen, NL: L.P.V. Berger, A.H. van der Hout, M.J.E. Mourits, G.H. de Bock; The Netherlands Comprehensive Cancer Organization (IKNL): S. Siesling, J. Verloop; The nationwide network and registry of histo- and cytopathology in The Netherlands (PALGA): E.C. van den Broek. The HEBON study is supported by the Dutch Cancer Society [Grant Nos. NKI1998-1854, NKI2004-3088, NKI2007-3756, NKI2019-12535], the Netherlands Organization of Scientific Research [Grant No. NWO 91109024], the Dutch Pink Ribbon foundation [Grant Nos. 110005 and 2014-187.WO76], BBMRI [Grant No. NWO 184.021.007/CP46] and Transcan [Grant No. JTC 2012 Cancer 12-054]. HEBON thanks the study participants and the registration teams of IKNL and PALGA for part of the data collection.

Funding Information:
The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON) consists of the following Collaborating Centers: Netherlands Cancer Institute (coordinating center), Amsterdam, NL: M.A. Rookus, F.B.L. Hogervorst, F.E. van Leeuwen, M.A. Adank, M.K. Schmidt, D.J. Stommel-Jenner, R. de Groot; Erasmus Medical Center, Rotterdam, NL: J.M. Collée, A.M.W. van den Ouweland, M.J. Hooning, I.A. Boere; Leiden University Medical Center, NL: C.J. van Asperen, P. Devilee, R.B. van der Luijt, T.C.T.E.F. van Cronenburg; Radboud University Nijmegen Medical Center, NL: M.R. Wevers, A.R. Mensenkamp; University Medical Center Utrecht, NL: M.G.E.M. Ausems, M.J. Koudijs; Amsterdam UMC, Univ of Amsterdam, NL: I. van de Beek; Amsterdam UMC, Vrije Universiteit Amsterdam, NL: K. van Engelen, J.J.P. Gille; Maastricht University Medical Center, NL: E.B. Gómez García, M.J. Blok, M. de Boer; University of Groningen, NL: L.P.V. Berger, A.H. van der Hout, M.J.E. Mourits, G.H. de Bock; The Netherlands Comprehensive Cancer Organization (IKNL): S. Siesling, J. Verloop; The nationwide network and registry of histo- and cytopathology in The Netherlands (PALGA): E.C. van den Broek. The HEBON study is supported by the Dutch Cancer Society [Grant Nos. NKI1998-1854, NKI2004-3088, NKI2007-3756, NKI2019-12535], the Netherlands Organization of Scientific Research [Grant No. NWO 91109024], the Dutch Pink Ribbon foundation [Grant Nos. 110005 and 2014-187.WO76], BBMRI [Grant No. NWO 184.021.007/CP46] and Transcan [Grant No. JTC 2012 Cancer 12-054]. HEBON thanks the study participants and the registration teams of IKNL and PALGA for part of the data collection.

Publisher Copyright:
© 2022, The Author(s).

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