Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study

Mark van Barele; Amy Rieborn; Bernadette A M Heemskerk-Gerritsen; Inge-Marie Obdeijn; Linetta B Koppert; Claudette E Loo; Rob A E M Tollenaar; Margreet G E M Ausems; Irma van de Beek; Lieke P V Berger; Maaike de Boer; Liselot P van Hest; C Marleen Kets; Matti Rookus; Marjanka K Schmidt; Agnes Jager; Maartje J Hooning; HEBON

doi:10.1007/s10549-022-06608-1

Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study

Mark van Barele, Amy Rieborn, Bernadette A M Heemskerk-Gerritsen, Inge-Marie Obdeijn, Linetta B Koppert, Claudette E Loo, Rob A E M Tollenaar, Margreet G E M Ausems, Irma van de Beek, Lieke P V Berger, Maaike de Boer, Liselot P van Hest, C Marleen Kets, Matti Rookus, Marjanka K Schmidt, Agnes Jager, Maartje J Hooning^*, HEBON

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

PURPOSE: Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.

METHODS: For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.

RESULTS: 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.

CONCLUSION: Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

Original language	English
Pages (from-to)	159-170
Number of pages	12
Journal	Breast Cancer Research and Treatment
Volume	194
Issue number	1
Early online date	4 May 2022
DOIs	https://doi.org/10.1007/s10549-022-06608-1
Publication status	Published - Jul 2022

Keywords

BRCA1
BRCA2
BRCA2 MUTATION CARRIERS
Breast cancer
LYMPH-NODE METASTASIS
MANAGEMENT
OUTCOMES
PREDICTOR
PROGNOSIS
STAGE
SUBTYPE
Survival
TUMOR SIZE
Tumor size
WOMEN

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Cite this

van Barele, M., Rieborn, A., Heemskerk-Gerritsen, B. A. M., Obdeijn, I.-M., Koppert, L. B., Loo, C. E., Tollenaar, R. A. E. M., Ausems, M. G. E. M., van de Beek, I., Berger, L. P. V., de Boer, M., van Hest, L. P., Kets, C. M., Rookus, M., Schmidt, M. K., Jager, A., Hooning, M. J., & HEBON (2022). Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study. Breast Cancer Research and Treatment, 194(1), 159-170. https://doi.org/10.1007/s10549-022-06608-1

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title = "Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study",

abstract = "PURPOSE: Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.METHODS: For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.RESULTS: 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.CONCLUSION: Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.",

keywords = "BRCA1, BRCA2, BRCA2 MUTATION CARRIERS, Breast cancer, LYMPH-NODE METASTASIS, MANAGEMENT, OUTCOMES, PREDICTOR, PROGNOSIS, STAGE, SUBTYPE, Survival, TUMOR SIZE, Tumor size, WOMEN",

author = "{van Barele}, Mark and Amy Rieborn and Heemskerk-Gerritsen, {Bernadette A M} and Inge-Marie Obdeijn and Koppert, {Linetta B} and Loo, {Claudette E} and Tollenaar, {Rob A E M} and Ausems, {Margreet G E M} and {van de Beek}, Irma and Berger, {Lieke P V} and {de Boer}, Maaike and {van Hest}, {Liselot P} and Kets, {C Marleen} and Matti Rookus and Schmidt, {Marjanka K} and Agnes Jager and Hooning, {Maartje J} and HEBON",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = jul,

doi = "10.1007/s10549-022-06608-1",

language = "English",

volume = "194",

pages = "159--170",

journal = "Breast Cancer Research and Treatment",

issn = "0167-6806",

publisher = "Springer, Cham",

number = "1",

}

van Barele, M, Rieborn, A, Heemskerk-Gerritsen, BAM, Obdeijn, I-M, Koppert, LB, Loo, CE, Tollenaar, RAEM, Ausems, MGEM, van de Beek, I, Berger, LPV, de Boer, M, van Hest, LP, Kets, CM, Rookus, M, Schmidt, MK, Jager, A, Hooning, MJ & HEBON 2022, 'Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study', Breast Cancer Research and Treatment, vol. 194, no. 1, pp. 159-170. https://doi.org/10.1007/s10549-022-06608-1

TY - JOUR

T1 - Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study

AU - van Barele, Mark

AU - Rieborn, Amy

AU - Heemskerk-Gerritsen, Bernadette A M

AU - Obdeijn, Inge-Marie

AU - Koppert, Linetta B

AU - Loo, Claudette E

AU - Tollenaar, Rob A E M

AU - Ausems, Margreet G E M

AU - van de Beek, Irma

AU - Berger, Lieke P V

AU - de Boer, Maaike

AU - van Hest, Liselot P

AU - Kets, C Marleen

AU - Rookus, Matti

AU - Schmidt, Marjanka K

AU - Jager, Agnes

AU - Hooning, Maartje J

AU - HEBON

PY - 2022/7

Y1 - 2022/7

N2 - PURPOSE: Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.METHODS: For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.RESULTS: 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.CONCLUSION: Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

AB - PURPOSE: Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.METHODS: For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.RESULTS: 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.CONCLUSION: Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

KW - BRCA1

KW - BRCA2

KW - BRCA2 MUTATION CARRIERS

KW - Breast cancer

KW - LYMPH-NODE METASTASIS

KW - MANAGEMENT

KW - OUTCOMES

KW - PREDICTOR

KW - PROGNOSIS

KW - STAGE

KW - SUBTYPE

KW - Survival

KW - TUMOR SIZE

KW - Tumor size

KW - WOMEN

U2 - 10.1007/s10549-022-06608-1

DO - 10.1007/s10549-022-06608-1

M3 - Article

C2 - 35507134

SN - 0167-6806

VL - 194

SP - 159

EP - 170

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

IS - 1

ER -