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Contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers
Journal of Clinical Oncology, 10/29/09

Graeser MK et al. –The goal of this study was to estimate the risk for contralateral breast cancer in members of BRCA1- and BRCA2-positive families and to determine predictive risk factors. Contralateral breast cancer risk depends on age at first breast cancer and on the affected BRCA gene, and this risk should be considered in treatment planning.

Methods

Retrospective, multicenter, cohort study
2,020 women with unilateral breast cancer from 978 families who had BRCA1 or BRCA2 mutation
Cox regression analysis applied to assess association of age at first breast cancer with time from first to contralateral breast cancer, stratified by affected BRCA gene

Results

Cumulative risk for contralateral breast cancer 25 years after first breast cancer 47.4% (95% CI, 38.8% to 56.0%) for patients from families with BRCA1 or BRCA2 mutations
Members of families with BRCA1 mutations had 1.6-fold (95% CI, 1.2-fold to 2.3-fold) higher risk of contralateral breast cancer than members of families with BRCA2 mutations
Members of families with BRCA1 mutations had 1.6-fold higher risk of contralateral breast cancer than members of families with BRCA2 mutations
Younger age at first breast cancer associated with significantly higher risk of contralateral breast cancer in patients with BRCA1 mutation
trend was observed in patients with BRCA2 mutation
After 25 years, 62.9% (95% CI, 50.4% to 75.4%) of patients with BRCA1 mutation who were younger than 40 years of age at first breast cancer developed contralateral breast cancer, compared with only 19.6% (95% CI, 5.3% to 33.9%) of those older than 50 years of age at first breast cancer