Poor Prognosis for BRCA1 Breast Cancer Patients

A review of clinical records has shown that breast cancer patients with an inherited mutation in the BRCA1 gene have a lower chance of survival, but that this prognosis is cancelled by treatment with chemotherapy, even when the woman was under 50 when diagnosed or if the tumor was larger than 2 cm.

Researchers studied the clinical records of 496 women of Ashkenazi Jewish descent who underwent treatment for invasive breast cancer between 1980 and 1995. The BRCA1 and BRCA2 gene mutations occur predominantly in women of Ashkenazi Jewish descent. The researchers found that 56 of the women carried at least one mutation in either the BRCA1 or BRCA2 gene. Within 10 years of diagnosis, 79 of the women died.

The 10-year survival rates for women with BRCA1 mutations were worse than those without mutations (38% of carriers died compared with 14% of noncarriers). However, if a woman was treated with chemotherapy, her long-term survival was not reduced. The 10-year survival rates for women with BRCA2 mutations did not differ from those of noncarriers, and chemotherapy did not affect survival rates of women in this group. However, the size of the sample may be too small for meaningful conclusions. The risk for breast cancer in the unaffected breast was much higher for women with BRCA1/2 mutations than for noncarriers, but the 10-year risk of the cancer recurring in the treated breast was no greater in women with the BRCA mutations.

The study was conducted by a team of researchers from McGill University (Montreal, Canada; www.mcgill.edu) and Memorial Sloan-Kettering Cancer Center (New York, NY, USA) and published online by BioMed Central.





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McGill University
Memorial Sloan-Kettering Cancer Center