January 11, 2018

expert reaction to study looking at survival in young women with breast cancer, with and without the BRCA mutation

A new study, published in the Lancet Oncology, reports that survival for young women treated for breast cancer is the same weather or not they carry a BRCA mutation.

Fiona MacNeill, Consultant Breast Surgeon, The Royal Marsden NHS Foundation Trust:

“This is an important large prospective national study in young high risk women (<40yrs) with breast cancer.  The study demonstrates that young women with triple negative breast cancer with or without a BRCA mutation have the same good 10 year survival (70-73%) when compared to young women with hormone sensitive cancers or without a BRCA gene mutation.  Nearly half of the BRCA mutation carriers and 60% of those with triple negative cancer had breast conservation and radiotherapy with the same good survival.  107 of the 338 BRCA mutation carriers had a double mastectomy (presumably to reduce the risk of a new breast cancer in the unaffected breast).  Double mastectomy did not show any survival advantage at 10 years.  However, it may be that any survival advantage to radical risk-reducing breast surgery in those already affected with breast cancer may not be demonstrated for 2-3 decades.

“This study can reassure young women with breast cancer, particularly those with triple negative cancer or who are BRCA carriers that breast conservation with radiotherapy is a safe option in the first decade after diagnosis and double mastectomy is not essential or mandatory at initial treatment.  In view of this, younger women with breast cancer can take time to discuss whether radical breast surgery is the right choice for them as part of a longer-term risk reducing strategy.”

* ‘Germline BRCA mutation and outcome in young-onset breast cancer (POSH): a prospective cohort study’ by Ellen R Copson et al. published in the Lancet Oncology on Thursday 11 January 2018.

Declared interests

None received.