Highlights
- •Breast cancer incidence was assessed in ovarian cancer patients carrying BRCA mutations.
- •Breast cancer was diagnosed after ovarian cancer in 6.2% of patients.
- •Overall survival was not statistically different in the patient groups analyzed.
- •Routine breast surveillance may be sufficient in ovarian cancer survivors.
Abstract
Objectives
We evaluated the incidence of breast cancer and overall survival in a multi-center
cohort of ovarian cancer patients carrying BRCA1/2 mutations in order to assess risks
and formulate optimal preventive interventions and/or surveillance.
Methods
Medical records of 502 BRCA1/2 mutation carriers diagnosed with ovarian cancer between
2000 and 2018 at 7 medical centers in Israel and one in New York were retrospectively
analyzed for breast cancer diagnosis. Data included demographics, type of BRCA mutations,
surveillance methods, timing of breast cancer diagnosis, and family history of cancer.
Results
The median age at diagnosis of ovarian cancer was 55.8 years (range, 23.9–90.1). A
third (31.5%) had a family history of breast cancer and 17.1% of ovarian cancer. Most
patients (67.3%) were Ashkenazi Jews, 72.9% were BRCA1 carriers. Breast cancer preceded
ovarian cancer in 17.5% and was diagnosed after ovarian cancer in 6.2%; an additional 2.2% had a synchronous presentation. Median
time to breast cancer diagnosis after ovarian cancer was 46.0 months (range, 11–168).
Of those diagnosed with both breast cancer and ovarian cancer (n = 31), 83.9% and 16.1% harbored BRCA1 and BRCA2 mutations, respectively. No deaths
from breast cancer were recorded. Overall survival did not differ statistically between
patients with an ovarian cancer diagnosis only and those diagnosed with breast cancer
after ovarian cancer.
Conclusion
The low incidence of breast cancer after ovarian cancer in women carrying BRCA1/2
mutations suggests that routine breast surveillance, rather than risk-reducing surgical
interventions, may be sufficient in ovarian cancer survivors.
Keywords
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Article info
Publication history
Published online: June 23, 2021
Accepted:
June 10,
2021
Received:
March 22,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
