INTRODUCTION: The optimal clinical management of breast cancer (BC) arising in BRCA1/2 mutations carriers is a difficult issue complicated by the risk of subsequent malignancies and by the potential differences in response to local and systemic therapies. AIM: Systematically review the difference in outcome after breast conservation therapy (BCT) and uni-or bilateral mastectomy in BRCA1/2 related BC. MATERIAL AND METHODS: We selected 20 studies, for which we evaluated the methodology, the characteristics of the populations, biases, confounding risk factors and outcomes. RESULTS: All studies are retrospective, entailed by numerous biases. They varied with respect to patients' number, selection, and confounding factors. Hereditary BC patients carried an increased risk of ipsilateral recurrence in 5/17 studies, a worse survival in 4/14, an increased risk of contralateral BC in 14/16. CONCLUSION: Except for contralateral risk, the presence of a BRCA mutation does not seem to offer additional prognostic information. Large prospective trials, stratified for risk reduction strategies are warranted.
INTRODUCTION: The optimal clinical management of breast cancer (BC) arising in BRCA1/2 mutations carriers is a difficult issue complicated by the risk of subsequent malignancies and by the potential differences in response to local and systemic therapies. AIM: Systematically review the difference in outcome after breast conservation therapy (BCT) and uni-or bilateral mastectomy in BRCA1/2 related BC. MATERIAL AND METHODS: We selected 20 studies, for which we evaluated the methodology, the characteristics of the populations, biases, confounding risk factors and outcomes. RESULTS: All studies are retrospective, entailed by numerous biases. They varied with respect to patients' number, selection, and confounding factors. Hereditary BC patients carried an increased risk of ipsilateral recurrence in 5/17 studies, a worse survival in 4/14, an increased risk of contralateral BC in 14/16. CONCLUSION: Except for contralateral risk, the presence of a BRCA mutation does not seem to offer additional prognostic information. Large prospective trials, stratified for risk reduction strategies are warranted.
Authors: Xinran Xu; Marilie D Gammon; Yujing Zhang; Yoon Hee Cho; James G Wetmur; Patrick T Bradshaw; Gail Garbowski; Hanina Hibshoosh; Susan L Teitelbaum; Alfred I Neugut; Regina M Santella; Jia Chen Journal: Breast Cancer Res Treat Date: 2009-11-17 Impact factor: 4.872
Authors: Xinran Xu; Marilie D Gammon; Yujing Zhang; Timothy H Bestor; Steven H Zeisel; James G Wetmur; Sylvan Wallenstein; Patrick T Bradshaw; Gail Garbowski; Susan L Teitelbaum; Alfred I Neugut; Regina M Santella; Jia Chen Journal: Breast Cancer Res Treat Date: 2008-06-03 Impact factor: 4.872
Authors: Hanna Fredholm; Sonja Eaker; Jan Frisell; Lars Holmberg; Irma Fredriksson; Henrik Lindman Journal: PLoS One Date: 2009-11-11 Impact factor: 3.240