Risk of Primary and Contralateral Breast Cancer after Ovarian Cancer in BRCA1/2 mutation carriers; is a prophylactic mastectomy justified?
7 slide(s) – English – 2011-09-11
So far, there are no available data about risk of PBC or CBC for BRCA1/2 mutation-carriers with a history of OC. Data hereon are warranted for optimal decision-making regarding surveillance or prophylactic mastectomy.
From the institutional database, we selected BRCA-associated OC-patients without (n=79; at risk of PBC) and with (n=37; at risk of CBC) a history of BC.
Controls were BRCA mutation-carriers without OC (302 without and 257 with a history of BC).
Risks for PBC and CBC were calculated using the Kaplan-Meier survival method with death prior to BC as competing risk event.
The 2-, 5- and 10-years risk of PBC was lower in OC patients compared with unaffected mutation carriers (3%, 6% and 11% versus 6%, 21% and 52%, p=0.005). The risk of death at the same timepoints was significantly higher in OC patients than in unaffected mutation carriers (13%, 33% and 61% versus 1%, 1% and 1% respectively).
In OC patients with a history of BC, the 2-, 5- and 10-years risk of CBC was lower than in BC patients without OC (0%, 7% and 7% versus 6%, 18% and 34%, p=0.003). At similar timepoints, the risk of death in OC patients was 19%, 34% and 55% versus 5%, 14% and 24% in patients without OC.
The risk of death after OC in BRCA mutation carriers is higher than the risk of developing a PBC or CBC. The data do not support a prophylactic mastectomy and suggest that surveillance strategies might be reconsidered.