Predictors of survival for breast cancer patients with a BRCA1 mutation

Steven A. Narod, Tomasz Huzarski, Jacek Gronwald, Tomasz Byrski, Elzbieta Marczyk, Cezary Cybulski, Marek Szwiec, Rafal Wisniowski, Bozena Birkenfeld, Ewa Kilar, Robert Sibilski, Ping Sun, Jan Lubinski

To evaluate in a contemporary cohort the impacts of chemotherapy and oophorectomy on survival for breast cancer patients with a BRCA1 mutation. We reviewed the pathology reports and medical records of 372 women with breast cancer and a BRCA1 mutation, diagnosed from 2005 to 2017, between the ages of 25 and 65 and followed them for death from all causes and death from breast cancer. Death was ascertained through the Poland vital statistics registry. We performed survival analysis to evaluate the impacts of chemotherapy (including neoadjuvant cisplatinum) and of oophorectomy on survival. After a mean follow-up of 5.6 years (median 5.2), 66 of the 372 women died; 56 of the deaths were from breast cancer and 6 were from ovarian cancer. 127 women received neoadjuvant cisplatinum and 245 women received other chemotherapies. Cisplatinum (versus all other therapies) was associated with a hazard ratio of 0.42 (95%CI 0.20-0.87) on breast cancer-specific survival. The 10-year actuarial all-cause survival for women who had both cisplatinum and an oophorectomy was 94.4%. The 10-year all-cause survival for women who had neither cisplatinum nor an oophorectomy was 65.4% (p < 0.01). Cisplatinum and oophorectomy are effective therapies for women with breast cancer and a BRCA1 mutation.