Survival in Norwegian BRCA1 mutation carriers with breast cancer

Abstract

Several studies of survival in women with BRCA1 mutations have shown either reduced survival or no difference compared to controls. Programmes for early detection and treatment of inherited breast cancer, have failed to demonstrate a significant improvement in survival in BRCA1 mutation carriers.One hundred and sixty-seven women with disease-associated germline BRCA1 mutations and breast cancer from 1980 to 2001 were identified. Tumour characteristics, treatment given and survival were recorded. A control group comprising three hundred and four women matched for age, time of diagnosis and stage were used to compare survival.BRCA1 mutation carriers were found to have a poorer prognosis, which could be explained by neither the mode of surgical treatment nor the use of adjuvant chemotherapy. BRCA1 mutation carriers with node negative breast cancer had worse overall survival than controls.Our findings confirm the serious prognosis of BRCA1-associated breast cancer even when diagnosed at an early stage, and that type of treatment does not influence prognosis.

Figure 1

Overall survival in cases stage 1, age ≤55 years, stratified on type of operation. Initial numbers in groups are indicated in the figure. Halsteds operation orange line. Breastconserving operation: red line. Mastectomy: blue line.

Figure 2

Overall survival in cases stage 1, stratified on chemotherapy or no chemotherapy (removal of those who had chemotherapy on days 0 and 7). Initial numbers in groups are indicated in the figure. No chemotherapy given: Red line. Chemotherapy given: Blue line.

Figure 3

Overall survival in cases and controls. Initial numbers in groups are indicated in the figure. Controls: Green line. Cases: Blue line.

Figure 4

Overall survival in stage 1 for cases and controls. Initial numbers in groups are indicated in the figure. Controls: Green line. Cases: Blue line.