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Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status
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 B...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686356/ https://www.ncbi.nlm.nih.gov/pubmed/32939053 http://dx.doi.org/10.1038/s41416-020-01056-4 |
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author | Olafsdottir, Elinborg J. Borg, Ake Jensen, Maj-Britt Gerdes, Anne-Marie Johansson, Anna L. V. Barkardottir, Rosa B. Johannsson, Oskar T. Ejlertsen, Bent Sønderstrup, Ida Marie Heeholm Hovig, Eivind Lænkholm, Anne-Vibeke Hansen, Thomas van Overeem Olafsdottir, Gudridur H. Rossing, Maria Jonasson, Jon G. Sigurdsson, Stefan Loman, Niklas Nilsson, Martin P. Narod, Steven A. Tryggvadottir, Laufey |
author_facet | Olafsdottir, Elinborg J. Borg, Ake Jensen, Maj-Britt Gerdes, Anne-Marie Johansson, Anna L. V. Barkardottir, Rosa B. Johannsson, Oskar T. Ejlertsen, Bent Sønderstrup, Ida Marie Heeholm Hovig, Eivind Lænkholm, Anne-Vibeke Hansen, Thomas van Overeem Olafsdottir, Gudridur H. Rossing, Maria Jonasson, Jon G. Sigurdsson, Stefan Loman, Niklas Nilsson, Martin P. Narod, Steven A. Tryggvadottir, Laufey |
author_sort | Olafsdottir, Elinborg J. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7686356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-76863562021-09-17 Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status Olafsdottir, Elinborg J. Borg, Ake Jensen, Maj-Britt Gerdes, Anne-Marie Johansson, Anna L. V. Barkardottir, Rosa B. Johannsson, Oskar T. Ejlertsen, Bent Sønderstrup, Ida Marie Heeholm Hovig, Eivind Lænkholm, Anne-Vibeke Hansen, Thomas van Overeem Olafsdottir, Gudridur H. Rossing, Maria Jonasson, Jon G. Sigurdsson, Stefan Loman, Niklas Nilsson, Martin P. Narod, Steven A. Tryggvadottir, Laufey Br J Cancer Article 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. Nature Publishing Group UK 2020-09-17 2020-11-24 /pmc/articles/PMC7686356/ /pubmed/32939053 http://dx.doi.org/10.1038/s41416-020-01056-4 Text en © The Author(s), under exclusive licence to Cancer Research UK 2020 https://creativecommons.org/licenses/by/4.0/Note This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0). |
spellingShingle | Article Olafsdottir, Elinborg J. Borg, Ake Jensen, Maj-Britt Gerdes, Anne-Marie Johansson, Anna L. V. Barkardottir, Rosa B. Johannsson, Oskar T. Ejlertsen, Bent Sønderstrup, Ida Marie Heeholm Hovig, Eivind Lænkholm, Anne-Vibeke Hansen, Thomas van Overeem Olafsdottir, Gudridur H. Rossing, Maria Jonasson, Jon G. Sigurdsson, Stefan Loman, Niklas Nilsson, Martin P. Narod, Steven A. Tryggvadottir, Laufey Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title | Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title_full | Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title_fullStr | Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title_full_unstemmed | Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title_short | Breast cancer survival in Nordic BRCA2 mutation carriers—unconventional association with oestrogen receptor status |
title_sort | breast cancer survival in nordic brca2 mutation carriers—unconventional association with oestrogen receptor status |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686356/ https://www.ncbi.nlm.nih.gov/pubmed/32939053 http://dx.doi.org/10.1038/s41416-020-01056-4 |
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