Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences
Background. Patients with unilateral breast cancer carrying pathogenic variants in BRCA1/2 have the option to undergo contralateral prophylactic mastectomy (CPM). However, differences in CPM use and survival outcomes following CPM are poorly understood in this high-risk population, in part due to a...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | The Breast Journal |
| Online Access: | http://dx.doi.org/10.1155/2022/1447545 |
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| author | Sukh Makhnoon Angelica M. Gutierrez Barrera Roland Bassett Aimaz Afrough Isabelle Bedrosian Banu K. Arun |
| author_facet | Sukh Makhnoon Angelica M. Gutierrez Barrera Roland Bassett Aimaz Afrough Isabelle Bedrosian Banu K. Arun |
| author_sort | Sukh Makhnoon |
| collection | DOAJ |
| description | Background. Patients with unilateral breast cancer carrying pathogenic variants in BRCA1/2 have the option to undergo contralateral prophylactic mastectomy (CPM). However, differences in CPM use and survival outcomes following CPM are poorly understood in this high-risk population, in part due to a lack of data from contemporary clinical cohorts. The objective of this study was to evaluate post-CPM overall survival (OS) and related racial/ethnic differences in a contemporary clinical cohort. Methods. We retrospectively reviewed the medical records of women with a personal history of unilateral breast cancer carrying pathogenic variants in BRCA1/2 who were diagnosed between 1996 and 2012. Genetic test results, self-reported demographic characteristics, and clinical factors were abstracted from electronic medical records. Results. Of 144 BRCA-positive patients, the majority were White (79.2%, n = 114). Overall, 56.1% (n = 81) of all BRCA1/2 carriers chose to undergo CPM, with no racial/ethnic difference in CPM election (p = 0.78). Of 81 patients who underwent CPM, there is strong evidence of a difference in survival between the racial/ethnic groups, with White patients having the highest OS compared to non-White patients (p = 0.001). Of the 63 patients who did not undergo CPM, there is no racial/ethnic difference in overall survival (p = 0.61). In multivariable cox regression, adjusted for demographic and clinical characteristics, OS was significantly lower among non-Whites than in Whites (HR = 0.39, p = 0.04). Conclusions. Evaluation of a contemporary clinical cohort of BRCA-positive women with unilateral breast cancer showed no racial/ethnic difference in CPM use, but there was a significant difference in post-CPM overall survival. |
| format | Article |
| id | doaj-art-a6b0af19cfa14ba8a1c4881337746306 |
| institution | Kabale University |
| issn | 1524-4741 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Breast Journal |
| spelling | doaj-art-a6b0af19cfa14ba8a1c48813377463062025-02-03T05:58:00ZengWileyThe Breast Journal1524-47412022-01-01202210.1155/2022/1447545Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic DifferencesSukh Makhnoon0Angelica M. Gutierrez Barrera1Roland Bassett2Aimaz Afrough3Isabelle Bedrosian4Banu K. Arun5Department of Behavioral ScienceDepartment of Breast Medical Oncology ResearchDepartment of BiostatisticsDepartment of Internal MedicineDepartment of Breast Surgical OncologyDepartment of Breast Medical Oncology ResearchBackground. Patients with unilateral breast cancer carrying pathogenic variants in BRCA1/2 have the option to undergo contralateral prophylactic mastectomy (CPM). However, differences in CPM use and survival outcomes following CPM are poorly understood in this high-risk population, in part due to a lack of data from contemporary clinical cohorts. The objective of this study was to evaluate post-CPM overall survival (OS) and related racial/ethnic differences in a contemporary clinical cohort. Methods. We retrospectively reviewed the medical records of women with a personal history of unilateral breast cancer carrying pathogenic variants in BRCA1/2 who were diagnosed between 1996 and 2012. Genetic test results, self-reported demographic characteristics, and clinical factors were abstracted from electronic medical records. Results. Of 144 BRCA-positive patients, the majority were White (79.2%, n = 114). Overall, 56.1% (n = 81) of all BRCA1/2 carriers chose to undergo CPM, with no racial/ethnic difference in CPM election (p = 0.78). Of 81 patients who underwent CPM, there is strong evidence of a difference in survival between the racial/ethnic groups, with White patients having the highest OS compared to non-White patients (p = 0.001). Of the 63 patients who did not undergo CPM, there is no racial/ethnic difference in overall survival (p = 0.61). In multivariable cox regression, adjusted for demographic and clinical characteristics, OS was significantly lower among non-Whites than in Whites (HR = 0.39, p = 0.04). Conclusions. Evaluation of a contemporary clinical cohort of BRCA-positive women with unilateral breast cancer showed no racial/ethnic difference in CPM use, but there was a significant difference in post-CPM overall survival.http://dx.doi.org/10.1155/2022/1447545 |
| spellingShingle | Sukh Makhnoon Angelica M. Gutierrez Barrera Roland Bassett Aimaz Afrough Isabelle Bedrosian Banu K. Arun Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences The Breast Journal |
| title | Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences |
| title_full | Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences |
| title_fullStr | Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences |
| title_full_unstemmed | Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences |
| title_short | Contralateral Prophylactic Mastectomy among Women with Pathogenic Variants in BRCA1/2: Overall Survival, Racial, and Ethnic Differences |
| title_sort | contralateral prophylactic mastectomy among women with pathogenic variants in brca1 2 overall survival racial and ethnic differences |
| url | http://dx.doi.org/10.1155/2022/1447545 |
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