Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study

Mark van Barele, Amy Rieborn, Bernadette A. M. Heemskerk-Gerritsen, Inge-Marie Obdeijn, Linetta B. Koppert, Claudette E. Loo, Rob A. E. M. Tollenaar, Margreet G. E. M. Ausems, Irma van de Beek, Lieke P. Berger, Maaike de Boer, Liselot P. van Hest, C. Marleen Kets, Matti Rookus, Hebon, Marjanka K. Schmidt, Agnes Jager, Maartje J. Hooning*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

1 Citaat (Scopus)
7 Downloads (Pure)


Purpose Intensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement. Methods For this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan-Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group. Results 963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21-1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a. Conclusion Smaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

Originele taal-2English
Pagina's (van-tot)159-170
Aantal pagina's12
TijdschriftBreast Cancer Research and Treatment
Vroegere onlinedatum4-mei-2022
StatusPublished - jul.-2022
Extern gepubliceerdJa

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