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. 2020 Nov;123(11):1608-1615.
doi: 10.1038/s41416-020-01056-4. Epub 2020 Sep 17.

Breast cancer survival in Nordic BRCA2 mutation carriers-unconventional association with oestrogen receptor status

Elinborg J Olafsdottir  1 , Ake Borg  2 , Maj-Britt Jensen  3 , Anne-Marie Gerdes  4 , Anna L V Johansson  5 , Rosa B Barkardottir  6   7 , Oskar T Johannsson  8 , Bent Ejlertsen  3   9 , Ida Marie Heeholm Sønderstrup  10 , Eivind Hovig  11 , Anne-Vibeke Lænkholm  12 , Thomas van Overeem Hansen  4 , Gudridur H Olafsdottir  1 , Maria Rossing  13 , Jon G Jonasson  14   15 , Stefan Sigurdsson  16 , Niklas Loman  2   17 , Martin P Nilsson  2   17 , Steven A Narod  18 , Laufey Tryggvadottir  19   20
Affiliations

Breast cancer survival in Nordic BRCA2 mutation carriers-unconventional association with oestrogen receptor status

Elinborg J Olafsdottir et al. Br J Cancer. 2020 Nov.

Abstract

Background: The natural history of breast cancer among BRCA2 carriers has not been clearly established. In a previous study from Iceland, positive ER status was a negative prognostic factor. We sought to identify factors that predicted survival after invasive breast cancer in an expanded cohort of BRCA2 carriers.

Methods: We studied 608 women with invasive breast cancer and a pathogenic BRCA2 mutation (variant) from four Nordic countries. Information on prognostic factors and treatment was retrieved from health records and by analysis of archived tissue specimens. Hazard ratios (HR) were estimated for breast cancer-specific survival using Cox regression.

Results: About 77% of cancers were ER-positive, with the highest proportion (83%) in patients under 40 years. ER-positive breast cancers were more likely to be node-positive (59%) than ER-negative cancers (34%) (P < 0.001). The survival analysis included 584 patients. Positive ER status was protective in the first 5 years from diagnosis (multivariate HR = 0.49; 95% CI 0.26-0.93, P = 0.03); thereafter, the effect was adverse (HR = 1.91; 95% CI 1.07-3.39, P = 0.03). The adverse effect of positive ER status was limited to women who did not undergo endocrine treatment (HR = 2.36; 95% CI 1.26-4.44, P = 0.01) and patients with intact ovaries (HR = 1.99; 95% CI 1.11-3.59, P = 0.02).

Conclusions: The adverse effect of a positive ER status in BRCA2 carriers with breast cancer may be contingent on exposure to ovarian hormones.

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Conflict of interest statement

Steven A. Narod is an Editorial board member to British Journal of Cancer.

Figures

Fig. 1
Fig. 1
Cumulative incidence of breast cancer death according to grade (deaths due to other causes treated as competing events).
Fig. 2
Fig. 2. Cumulative incidence of breast cancer death according to ER status, stratified on oophorectomy and endocrine therapy (deaths due to other causes treated as competing events).
a Without stratification. b Patients who did not undergo early oophorectomy. c Patients who underwent early oophorectomy. d Patients who did not receive endocrine therapy. e Patients who received endocrine therapy.
See this image and copyright information in PMC

References

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