Medline ® Abstract for Reference 57
of 'Genetic counseling and testing for hereditary breast and ovarian cancer'
No evidence of excess breast cancer risk among mutation-negative women from BRCA mutation-positive families.
Korde LA, Mueller CM, Loud JT, Struewing JP, Nichols K, Greene MH, Mai PL
Breast Cancer Res Treat. 2011;125(1):169. Epub 2010 May 11.
This analysis addresses risk of breast cancer among women in BRCA-positive families who test negative for the family mutation. We compared the number of prospectively diagnosed breast cancers in 395 mutation-negative women from 28 BRCA1/2-positive families to an age-, race-, and calendar time-specific expected number of breast cancers derived from the SEER 9 Cancer Registry. Study participants contributed a total of 7008.1 person-years of follow-up. The mean age at study entry was 31.3 years; mean follow-up was 17.7 years. Ten women developed breast cancer yielding an observed-to-expected ratio of 0.82 (95% CI 0.39-1.51). Adjustment for possible reduction in breast cancer risk due to oophorectomy by two different methods resulted in O/E ratios in the range of 0.80-0.99. Stratification by degree of relatedness to the nearest mutation carrier did not substantially alter these results, however, women with at least one-first degree relative with breast cancer appeared to have a slightly increased, though not statistically significant, risk of breast cancer (O/E ratio = 1.33, 95% CI 0.41-2.91). Our data suggest that breast cancer risk among mutation-negative women from BRCA1/2 mutation-positive families is similar to that observed in the general population, with a possible slight increase in risk among mutation-negative women with a family history of breast cancer in a first degree relative. Although this is the largest prospective cohort yet assembled to address this important question, the number of breast cancer events is still relatively small.
Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, 825 Eastlake Ave, E., G3-630, Seattle, WA 98109, USA. Lkorde@u.washington.edu