Breast cancer: BRCA2+ status tied to higher risk for CNS metastasis

  • Song Y & al.
  • Cancer
  • 3 Oct 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • The BRCA2 mutation is tied to a higher incidence of central nervous system (CNS) metastasis in breast cancer.
  • No association found for BRCA1+ status.

Why this matters

  • First study to present a link between BRCA2+status and CNS involvement.

Study design

  • Retrospective study (n=332) of all patients treated for recurrent breast cancer who underwent BRCA testing (1981-2014) at the Dana-Farber Cancer Institute.
  • Funding: None disclosed.

Key results

  • 73% of BRCA1+ patients had triple-negative breast cancer (TNBC), whereas 72% of BRCA2+ patients had hormone receptor-positive primary tumors.
  • The most common type of metastasis (as first/subsequent metastases) varied by BRCA status:
    • 50% of BRCA1+ carriers had lung metastases and 50% had distant lymph node metastasis.
    • 75% of BRCA2+ carriers and 53% of noncarriers had bone metastasis.
  • In univariate analysis, CNS disease was common among BRCA1+ (53%) and BRCA2+carriers vs noncarriers (53% and 50% vs 25%).
  • In multivariate analysis, only the BRCA2 mutation (OR, 3.33; P=.006 vs noncarrier) was associated with CNS metastasis after controlling for tumor subtype.
  • Cancer-related mortality was more likely with:
    • BRCA2+status vs noncarriers (HR, 1.82; P=.01).
    • TNBC primary subtype vs other subtypes (HR, 4.22; P<.01>
    • CNS involvement vs locoregional/contralateral disease (HR, 10.91; P<.001>

Limitations

  • Retrospective, observational design.
  • Single-institution study.