1. Familial versus Sporadic Breast Cancer: Different Treatments for Similar Tumors?
- Author
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Ellen G. Engelhardt, Mieke Kriege, Maartje J. Hooning, Caroline Seynaeve, Rob A. E. M. Tollenaar, Christina J. van Asperen, Margreet G. E. M. Ausems, Lonneke V. van de Poll-Franse, Stella Mook, Senno Verhoef, Matti A. Rookus, HEBON Collaborators, and Marjanka K. Schmidt
- Subjects
Oncology ,medicine.medical_specialty ,education.field_of_study ,endocrine system diseases ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Population ,medicine.disease ,Logistic regression ,Breast cancer ,Internal medicine ,medicine ,Family history ,skin and connective tissue diseases ,Ovarian cancer ,education ,business ,General Economics, Econometrics and Finance ,Estrogen Receptor Status ,Mastectomy ,Genetic testing - Abstract
Objective: It is unclear if and to what extent family history of breast/ovarian cancer or BRCA1/2-mutation carriership influences breast cancer treatment strategy. We investigated whether treatment differed between patients from BRCA1/2 families and those unselected for family history. Methods: We included 478 BRCA1/2-related patients referred for genetic testing before or after diagnosis. Two references were used: 13,498 population-based and 6896 hospital-based patients. Surgical treatment and adjuvant chemotherapy use was analyzed using logistic regression models, stratified by tumor size, nodal status, age at and period of diagnosis, and estrogen receptor status (ER). Results: BRCA1/2 cases aged 35 - 52 years at diagnosis and/or with tumors BRCA1 and ER-negative BRCA1/2-cases irrespective of age and nodal status (OR 1.9 to 24.3). Conclusion: After 1995 treatment of BRCA1/2-associated patients consisted notably of more mastectomies and adjuvant chemotherapy than their population-based counterparts with the same tumor characteristics. There is a need to be aware of such differences in daily practice and interpretation of survival studies on BRCA1/2 mutation carriers.
- Published
- 2015
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