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Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers

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Abstract

Women with a BRCA1 or BRCA2 mutation have an elevated risk of breast cancer and of contralateral breast cancer. In this study, we estimate the risk of non-synchronous ipsilateral breast cancer after a diagnosis of breast cancer in BRCA carriers and evaluate the effects of various treatments on this risk. Patients were 396 women with stage I or stage II breast cancer with an intact ipsilateral breast and for whom a BRCA1 or BRCA2 mutation had been identified in the family. Patients were followed from the initial diagnosis of cancer until the first of ipsilateral mastectomy, ipsilateral breast cancer, death or last follow-up. The 5-year actuarial risk of ipsilateral breast cancer was 5.8% (95% CI 3.2–8.4%) and the 10-year risk was 12.9% (95% CI 8.7–17.1%). Subjects who received chemotherapy had a significantly lower risk of ipsilateral breast cancer compared to those who did not receive chemotherapy (RR 0.45; 95% CI 0.24–0.84; P = 0.01). Radiotherapy was associated with a reduced risk of ipsilateral breast cancer (RR 0.28; 95% CI 0.12–0.63; P = 0.002). Oophorectomy was associated with a significant reduction in the risk of ipsilateral breast cancer (RR 0.33; 95% CI; 0.13–0.81; P = 0.02). On average, following a diagnosis of breast cancer, the annual risk of ipsilateral breast cancer risk in BRCA mutation carriers is 1.2% per year. For women treated with chemotherapy, radiation therapy or oophorectomy the risk is low, compared to women who did not receive any of these treatments.

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Acknowledgments

This research was funded by the Canadian Breast Cancer Foundation (Ontario Chapter). Dr. Metcalfe is supported by the Canadian Institutes of Health Research and the Ontario Women’s Health Council.

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Authors and Affiliations

  1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada

    Kelly Metcalfe

  2. Women’s College Research Institute, 790 Bay Street, Room 750, Toronto, ON, M5G 1N8, Canada

    Kelly Metcalfe, Ping Sun & Steven A. Narod

  3. Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA

    Henry T. Lynch

  4. Epidemiology Research Unit, Centre Hospitalier de Université de Montreal (CHUM), Montreal, Canada

    Parviz Ghadirian

  5. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Nadine Tung

  6. BC Cancer Agency, Vancouver, BC, Canada

    Charmaine Kim-Sing

  7. Department of Medicine, University of Chicago, Chicago, IL, USA

    Olufunmilayo I. Olopade

  8. Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, PA, USA

    Susan Domchek

  9. Department of Hematology/Oncology, University of Pennsylvania, Philadelphia, PA, USA

    Susan Domchek

  10. Sunnybrook Odette Cancer Center, Toronto, Canada

    Andrea Eisen & Danny Vesprini

  11. Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, Canada

    William D. Foulkes

  12. University Health Network, Toronto, Canada

    Barry Rosen

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  1. Kelly Metcalfe
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  2. Henry T. Lynch
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  3. Parviz Ghadirian
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  13. Steven A. Narod
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Correspondence to Steven A. Narod.

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Metcalfe, K., Lynch, H.T., Ghadirian, P. et al. Risk of ipsilateral breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 127, 287–296 (2011). https://doi.org/10.1007/s10549-010-1336-7

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  • DOI: https://doi.org/10.1007/s10549-010-1336-7

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