Tamoxifen and risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers.
نویسندگان
چکیده
PURPOSE To determine whether adjuvant tamoxifen treatment for breast cancer (BC) is associated with reduced contralateral breast cancer (CBC) risk for BRCA1 and/or BRCA2 mutation carriers. METHODS Analysis of pooled observational cohort data, self-reported at enrollment and at follow-up from the International BRCA1, and BRCA2 Carrier Cohort Study, Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, and Breast Cancer Family Registry. Eligible women were BRCA1 and BRCA2 mutation carriers diagnosed with unilateral BC since 1970 and no other invasive cancer or tamoxifen use before first BC. Hazard ratios (HRs) for CBC associated with tamoxifen use were estimated using Cox regression, adjusting for year and age of diagnosis, country, and bilateral oophorectomy and censoring at contralateral mastectomy, death, or loss to follow-up. RESULTS Of 1,583 BRCA1 and 881 BRCA2 mutation carriers, 383 (24%) and 454 (52%), respectively, took tamoxifen after first BC diagnosis. There were 520 CBCs over 20,104 person-years of observation. The adjusted HR estimates were 0.38 (95% CI, 0.27 to 0.55) and 0.33 (95% CI, 0.22 to 0.50) for BRCA1 and BRCA2 mutation carriers, respectively. After left truncating at recruitment to the cohort, adjusted HR estimates were 0.58 (95% CI, 0.29 to 1.13) and 0.48 (95% CI, 0.22 to 1.05) based on 657 BRCA1 and 426 BRCA2 mutation carriers with 100 CBCs over 4,392 person-years of prospective follow-up. HRs did not differ by estrogen receptor status of the first BC (missing for 56% of cases). CONCLUSION This study provides evidence that tamoxifen use is associated with a reduction in CBC risk for BRCA1 and BRCA2 mutation carriers. Further follow-up of these cohorts will provide increased statistical power for future prospective analyses.
منابع مشابه
Regarding the Use of Tamoxifen Post-Oophorectomy to Prevent Hereditary Breast Cancer
Options for the prevention of breast cancer in carriers of a BRCA1 or BRCA2 mutation include oophorectomy and tamoxifen [1]. It is possible to reduce the risk of breast cancer by 60% by performing surgical menopause at age 40 or before [2]; however, given the projected lifetime risk of 80% and penetrance of 30% by age 40, this leaves a residual risk post-oophorectomy of 30%. What can be done to...
متن کاملPersonalized medicine: a personal view.
testing over the Internet, and collaborative groups of researchers are pursuing genetic variants that may, singly or in combination, define cohorts of women at higher-than-average risk of breast cancer and other diseases. Much is promised, but to date, little has been demonstrated. For evaluative purposes, it may be illustrative to consider the case of tamoxifen chemoprevention for carriers of ...
متن کاملAssociation of tamoxifen use and reduced risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers
Patients and methods Female BRCA1 and BRCA2 mutation carriers, with a personal history of BC since 1970, enrolled in any of the BC family studies, kConFab (Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer), IBCCS (International BRCA1 and BRCA2 Carrier Cohort Study), or BCFR (Breast Cancer Family Registry) were eligible. Those with bilateral disease at first BC d...
متن کاملPopulation-based study of the risk of second primary contralateral breast cancer associated with carrying a mutation in BRCA1 or BRCA2.
PURPOSE Women with breast cancer diagnosed early in life comprise a substantial portion of those tested for BRCA1/BRCA2 mutations; however, little information is available on the subsequent risks of contralateral breast cancer in mutation carriers. This study assessed the risk of subsequent contralateral breast cancer associated with carrying a BRCA1 or BRCA2 mutation. PATIENTS AND METHODS In...
متن کاملVariation of breast cancer risk among BRCA1/2 carriers.
CONTEXT The risk of breast cancer in BRCA1 and BRCA2 mutation carriers has been examined in many studies, but relatively little attention has been paid to the degree to which the risk may vary among carriers. OBJECTIVES To determine the extent to which risks for BRCA1 and BRCA2 carriers vary with respect to observable and unobservable characteristics. DESIGN, SETTING, AND PARTICIPANTS Proba...
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عنوان ژورنال:
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
دوره 31 25 شماره
صفحات -
تاریخ انتشار 2013