After treatment, young women diagnosed with breast cancer who carry a BRCA mutation have the same chances of survival as women without the mutation, according to a prospective cohort study published in The Lancet Oncology.
The prospective cohort study, led by the University of Southampton, recruited 2733 young women with breast cancer aged 40 years and younger with the first diagnosis of invasive breast cancer between 2000 and 2008, when BRCA testing and risk-reducing surgery were not routine for early breast cancer. All women included in the study were tested for BRCA mutations, and 12% were found to carry mutation.
The majority of the participants (89%) received chemotherapy. Half underwent breast-conserving surgery (49%), half had mastectomy (50%), and less than 1% (16/2733 women) had no breast surgery. Over a median follow-up time of 8.2 years, there were 678 deaths, including 651 deaths from breast cancer, 18 from other cancers, and 9 from other causes.
The study found no difference in OS between women with and without a BRCA mutation. 2-year survival was 97.0% for BRCA carriers vs 96.6% for noncarriers. Survival at 5 and 10 years were 83.8% vs 85.0% and 73.4% vs 70.1%, respectively. The findings remained similar regardless of whether mutations were in the BRCA1 or BRCA2 gene, and when controlled for BMI and ethnicity.
Subgroup analysis of women with triple-negative breast cancer suggested BRCA carriers may initially have better survival than women without the mutation, but survival was similar at 5 or 10 years. The initial survival benefit was not associated with early risk-reducing surgery.
