The risk of primary and contralateral breast cancer after ovarian cancer in BRCA1/BRCA2 mutation carriers

Implications for counseling

Authors

  • Peggy M. L. H. Vencken MD,

    1. Department of Gynecological Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Mieke Kriege PhD,

    1. Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Maartje Hooning PhD,

    1. Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Marian B. Menke-Pluymers MD, PhD,

    1. Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Bernadette A. M. Heemskerk-Gerritsen MSc,

    1. Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Lena C. van Doorn MD, PhD,

    1. Department of Gynecological Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Margriet M. Collée MD, PhD,

    1. Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Agnes Jager MD, PhD,

    1. Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Cees van Montfort PhD,

    1. Department of Statistics, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Curt W. Burger MD, PhD,

    1. Department of Gynecological Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
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  • Caroline Seynaeve MD, PhD

    Corresponding author
    1. Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands
    • Department of Medical Oncology, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075 EA Rotterdam, the Netherlands
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    • Fax: (011) 31-10-7041003


Abstract

BACKGROUND:

The objective of this study was to assess the incidence of primary breast cancer (PBC) and contralateral breast cancer (CBC) in patients who had BRCA1/BRCA2-associated epithelial ovarian cancer (OC).

METHODS:

From the database of the Rotterdam Family Cancer Clinic, patients who had BRCA-associated OC without a history of unilateral breast cancer (BC) (at risk of PBC; n = 79) or with a history of unilateral BC (at risk of CBC; n = 37) were selected. The control groups consisted of unaffected BRCA mutation carriers (n = 351) or mutation carriers who had a previous unilateral BC (n = 294), respectively. The risks of PBC and CBC were calculated using the Kaplan-Meier survival method with death considered as a competing risk event.

RESULTS:

Women with BRCA-associated OC had lower 2-year, 5-year, and 10-year risks of PBC (3%, 6%, and 11%, respectively) compared with unaffected mutation carriers (6%, 16%, and 28%, respectively; P = .03), although they had a considerably higher mortality rate at similar time points (13%, 33%, and 61%, respectively, vs 1%, 2%, and 2%, respectively; P < .001). In BRCA mutation carriers with a previous unilateral BC, the 2-year, 5-year, and 10-year risks of CBC were nonsignificantly lower in patients with OC than in those without OC (0%, 7%, and 7%, respectively, vs 6%, 16%, and 34%, respectively; P = .06), whereas the mortality rate was higher in patients with OC (19%, 34%, and 55%, respectively, vs 4%, 11%, and 21%, respectively; P < .001).

CONCLUSIONS:

Patients with BRCA-associated OC had a lower risk of developing a subsequent PBC or CBC than mutation carriers without OC, whereas the risk of dying from OC was greater than the risk of developing BC. These data may facilitate more tailored counseling for this patient subgroup, although confirmative studies are warranted. Cancer 2013. © 2012 American Cancer Society.

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