752P - Prognosis of BRCA1 and BRCA2-related breast cancers: are there differences?

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer
Pathology/Molecular Biology
Translational Research
Presenter Zelmira Ballatore
Citation Annals of Oncology (2014) 25 (suppl_4): iv254-iv254. 10.1093/annonc/mdu335
Authors Z. Ballatore1, M. Pistelli1, R. Bracci1, F. Bianchi2, M. De Lisa3, M. Napolitano3, A. Pagliacci4, N. Battelli5, F. Ridolfi5, E. Maccaroni3, A. Santinelli6, T. Biscotti6, R. Berardi3, S. Cascinu3
  • 1Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy., Clinica di Oncologia Medica, 60020 - ANCONA/IT
  • 2Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy, Centro Regionale di Genetica Oncologica, 60020 - ancona/IT
  • 3Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy., Clinica di Oncologia Medica, 60020 - ancona/IT
  • 4, Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy., CLINICA DI ONCOLOGIA MEDICA, 60020 - ancona/IT
  • 5, Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy., CLINICA DI ONCOLOGIA MEDICA, 60020 - ANCONA/IT
  • 6Ao Ospedali Riuniti-ancona, Università Politecnica Delle Marche, Ancona, Italy., Anatomia Patologica,, 60020 - ancona/IT

Abstract

Aim

Many studies suggest that breast cancer prognosis may differ in women with BRCA germ-lines mutation compared with those with sporadic disease, but BRCA1 and BRCA2 subgroup' differences are still unclear. The aim of our survey was to highlight clinical outcomes of BRCA1 and BRCA2-related breast cancers in a consecutive monoinstitutional series of patients.

Methods

We included all deleteriously mutated breast cancer patients who underwent genetic testing at the Genetic Oncology Center of the Marche Region from January 1996 to December 2013. Subgroup differences were analysed using Chi Square Test. Data were tested at a statistical significance level of p < 0.05. The Cox univariate and multivariate proportional hazard regression model was used to evaluate the prognostic factors on overall survival (OS).

Results

92 cases (84 female and 8 male) of hereditary breast cancer were included. BRCA1 and BRCA2-associated breast cancers were 46.7% and 52.2%, respectively, while one patient reported pathogenetic mutation in both genes. Median age at diagnosis was 44 years (range 22-79). Most of patients (62%) were 45 years or younger and in a pre-menopausal status (69.9%). Up to date, there were 17 deaths (11.6%). BRCA2-related breast cancer presented more often lympho-vascular invasion (35.4% vs 13.9%, p = 0.03) and positive estrogen (72% vs 16.7%, p < 0.01) or progesterone receptors (74.4% vs 25%, p < 0.01) than BRCA1 cases. Univariate analysis showed that tumor size (p < 0.01), node status (p < 0.01), lympho-vascular invasion (p = 0.04) and BRCA2 related breast cancer (p = 0.03) are significant risk factors for OS. At multivariate analysis tumor size (p < 0.01) and axillary node status (p < 0.01) were independent prognostic variables influencing OS.

Conclusions

Our study showed that tumor size and node status are strongly related to BRCA-associated breast cancer prognosis. These data are in accordance with other studies about sporadic breast cancers. At univariate analysis, the result of worse OS rate in BRCA2 carriers seems to reflect more adverse tumor characteristics than in BRCA1 tumors, such as lympho-vascular invasion which is related to higher risk of relapse and to a worse prognosis.

Disclosure

All authors have declared no conflicts of interest.