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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Friday, May 10, 2024
Although women with BRCA1/2-mutated breast cancer have been found to have a heightened risk of experiencing ipsilateral and contralateral breast cancer events after undergoing breast-conserving therapy, in an analysis conducted by Kerollos N. Wanis, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, most of the cohort did not have another cancer event and remained bilateral mastectomy–free at 10 years. Their findings, which were presented during the 2024 Society of Surgical Oncology (SSO) Annual Meeting (Abstract 12), may aid in shared decision-making.
“While most women with BRCA-associated breast cancer choose bilateral mastectomy, current guidelines support breast-conserving therapy as an option in this population,” the investigators commented.
In this analysis, they assessed the clinical outcomes of 172 women with pathogenic BRCA1/2 mutations who underwent breast-conserving therapy between 1977 and 2021. The median age at diagnosis was 42 years. Patients with BRCA1 (n = 92) vs BRCA2 (n = 80) mutations appeared to be more likely to be younger at diagnosis, more often premenopausal, more likely to be White, less likely to have hormone receptor–positive tumors, and less likely to receive endocrine therapy.
Follow-up data were provided for a median of 11.8 years. The estimated rates of 10-year overall survival, survival without bilateral mastectomy because of a cancer event, risk of an ipsilateral breast cancer event, and risk of contralateral cancer were 88.5%, 81.3%, 12.3%, and 21.4%, respectively. According to the investigators, risks continued to increase after 10 years of follow-up. A multivariate analysis revealed that bilateral salpingo-oophorectomy was associated with a decreased hazard of ipsilateral breast cancer (hazard ratio [HR] = 0.24; P = .02); patients with BRCA2 mutations were reported to have a marginally decreased hazard of contralateral cancer (HR = 0.45; P = .09).
Disclosure: Dr. Wanis reported no conflicts of interest. For full disclosures of the other study authors, visit sso2024.eventscribe.net.
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