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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Wednesday, June 26, 2024
Limited evidence exists regarding the impact of hormone receptor status on clinical behavior and outcomes in young patients with early-stage invasive breast cancer harboring germline BRCA pathogenic variants, according to Luca Arecco, MD, of the University of Genoa, Italy, and colleagues. They thus conducted an international, multicenter, hospital-based, retrospective cohort study and presented their findings during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 504).
“Hormone receptor status did not appear to be a positive prognostic factor,” the investigators commented. “The differences in pattern of recurrence and second primary breast cancer among hormone receptor–positive vs –negative disease warrants consideration in counseling patients on treatment, follow-up strategies, and indication for risk-reducing surgery.”
The investigators focused on 4,709 BRCA1/2-variant carriers (aged 40 and younger) who were diagnosed between January 2000 and December 2020. Of this population, 45.5% and 54.5% had hormone receptor–positive and –negative disease, respectively. Follow-up data were provided for a median of 7.9 years.
Patients with hormone receptor–positive vs –negative disease demonstrated a higher rate of distant recurrences (13.1% vs 9.6%; P < .001) and a lower rate of second primary breast cancer (9.1% vs 14.7%; P < .001). The 8-year disease-free survival rates were 65.8% and 63.4%, respectively. Regarding overall and breast cancer–specific survival, no differences were observed. The hazard ratio appeared to change over time for disease-free, breast cancer–specific, and overall survival (P < .05 for interactions of hormone receptor status and survival time).
Among the 4,363 patients eligible for subtypes analysis, 612 had luminal A–like, 1,038 had luminal B–like, 2,373 had triple-negative, and 340 had HER2-positive disease. Those with luminal A–like disease were found to have the worst long-term prognosis (8-year disease-free survival: 60.8% [luminal A–like] vs 63.5% [triple-negative] vs 65.5% [HER2-positive] vs 69.7% [luminal B–like]).
Disclosure: Dr. Arecco reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.
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