Patterns of recurrence and metastasis in BRCA1/BRCA2‐associated breast cancers

Background Breast cancer subtypes are associated with distinct metastatic patterns. Whether germline BRCA1/BRCA2 mutation status is independently associated with central nervous system (CNS) relapse, controlling for tumor subtype, is unknown. Methods Patients who were treated at Dana‐Farber Cancer I...

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Bibliographic Details
Published in:Cancer 2020-01, Vol.126 (2), p.271-280
Main Authors: Song, Yun, Barry, William T., Seah, Davinia S., Tung, Nadine M., Garber, Judy E., Lin, Nancy U.
Format: Article
Language:English
Subjects:
Brain cancer
brain metastases
BRCA1
BRCA1 protein
BRCA2
BRCA2 protein
Breast cancer
Central nervous system
Health risk assessment
Health risks
Lymph nodes
Metastases
Metastasis
Multivariable control
Mutation
Oncology
Original
recurrence
Regression analysis
Regression models
Tumors
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Summary:Background Breast cancer subtypes are associated with distinct metastatic patterns. Whether germline BRCA1/BRCA2 mutation status is independently associated with central nervous system (CNS) relapse, controlling for tumor subtype, is unknown. Methods Patients who were treated at Dana‐Farber Cancer Institute and diagnosed with a first locoregional recurrence (LRR) or metastasis between 1981 and 2014 were identified using 2 institutional registries: 1) patients treated for recurrent breast cancer and 2) patients who underwent BRCA testing. The frequencies of LRR, sites of metastasis, and breast cancer‐specific survival from LRR or metastasis were calculated, and the factors associated with CNS recurrence were evaluated using multivariable logistic regression models. Results The final study cohort included 30 BRCA1 mutation carriers, 32 BRCA2 mutation carriers, and 270 noncarriers. Most BRCA1 carriers (73%) had triple‐negative breast cancer; whereas most BRCA2 carriers (72%) had hormone receptor‐positive tumors. BRCA1 carriers frequently experienced lung and distant lymph node metastasis, whereas BRCA2 carriers and noncarriers most often experienced bone metastasis. Although CNS disease occurred frequently in both BRCA1 and BRCA2 carriers (53% BRCA1, 50% BRCA2, 25% noncarriers; P 
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.32540