Site Editor
William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Friday, December 16, 2022
Siddhartha Yadav, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues aimed to estimate the risk of contralateral breast cancer among women who harbor germline pathogenic variants in genes BRCA1, BRCA2, ATM, PALB2, and CHEK2. Presented during the 2022 San Antonio Breast Cancer Symposium (SABCS; Abstract GS4-04), the results of this study concluded that these women are “at a substantially increased risk of contralateral breast cancer and may benefit from enhanced surveillance and risk-reduction strategies.”
The investigators identified a subset of 14,237 women from population-based studies and the CARRIERS study who were treated with ipsilateral surgery for invasive breast cancer. For pathogenic germline carriers, the risk of contralateral breast cancer was estimated via multivariate proportional hazard regression analysis. The analysis adjusted for tumor and patient characteristics and accounted for the competing risk of death.
Primary study endpoints focused on the cohort in general, as well as women from the general population. Secondary endpoints determined correlations by age at primary breast cancer diagnosis, tumor estrogen receptor status, race or ethnicity, and menopausal status.
A significantly elevated risk (P < .05) of contralateral breast cancer was observed in patients with BRCA1, BRCA2, and CHEK2, whereas only carriers of PALB2 pathogenic variants who had estrogen receptor–negative breast cancer demonstrated an elevated risk. In contrast, carriers of ATM pathogenic variants were not observed to have a significantly increased risk of contralateral breast cancer.
Patients who identified as African American had elevated risks of contralateral breast cancer similar to those identifying as non-Hispanic White. Additionally, the 15-year cumulative incidence rate of contralateral breast cancer among premenopausal women was more than 20% for BRCA1, BRCA2, and CHEK2 pathogenic variant carriers and PALB2 carriers with estrogen receptor–negative breast cancer. Among postmenopausal carriers, the 15-year cumulative incidence rate was less than 20% across all five genes.
Disclosure: For disclosures of the study authors, visit www.sabcs.org.
2022 San Antonio Breast Cancer Symposium
JNCCN Spotlights
Resources
For your Patients
