Selman Emiroglu, Enver Özkurt, Neslihan Cabıoglu, Abdullah Igci, Pinar Saip, Hulya Yazici, Tolga Ozmen, Vahit Ozmen, Mahmut Muslumanoglu, Mustafa Tukenmez
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Effects of the performed breast surgery and clinicopathological characteristics on surgical outcomes, LR rates and survival were analyzed with showing the distribution of <i>BRCA1</i> and <i>BRCA2</i> germline mutations.</p><p><strong>Results: </strong>The median age of the patients was 42 years (20-77). <i>BRCA1</i> mutations were found in 46 (61.3%) patients and <i>BRCA2</i> mutations in 29 (38.7%) patients. Compared to <i>BRCA2</i> carriers, <i>BRCA1</i> carriers were more likely to have higher tumor grade (84.8% vs 44.8%; <i>p</i> = 0.001) and non-luminal subtype tumors (67.4% vs 13.8%; <i>p</i> = 0.001). A total of 44 (58.7%) patients underwent unilateral mastectomy and 31 (41.3%) patients underwent BCS. At a median follow-up time of 60 (12-240) months, LR was observed in 6 patients equally divided in both BCS and mastectomy groups. LR rates were slightly higher after BCS versus mastectomy (9.7% and 6.8%, respectively). Additionally, there were no statistically significant differences in disease-free survival (DFS) and disease-specific survival (DSS) rates after 10 years in the BCS group versus the mastectomy group (<i>p</i> = 0.117 and 0.109, respectively), but in fact, the rates were better in the BCS group.</p><p><strong>Conclusion: </strong>Our findings indicate that BCS may serve as an efficacious alternative to mastectomy for breast cancer patients with <i>BRCA1</i> or <i>BRCA2</i> mutation. 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Compared to <i>BRCA2</i> carriers, <i>BRCA1</i> carriers were more likely to have higher tumor grade (84.8% vs 44.8%; <i>p</i> = 0.001) and non-luminal subtype tumors (67.4% vs 13.8%; <i>p</i> = 0.001). A total of 44 (58.7%) patients underwent unilateral mastectomy and 31 (41.3%) patients underwent BCS. At a median follow-up time of 60 (12-240) months, LR was observed in 6 patients equally divided in both BCS and mastectomy groups. LR rates were slightly higher after BCS versus mastectomy (9.7% and 6.8%, respectively). 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引用次数: 0
摘要
背景:对于新诊断的易感基因发生种系突变的乳腺癌，最佳的手术治疗方法对许多医生来说仍然不确定。在这项研究中，我们旨在通过评估保乳手术(BCS)的结果和局部复发率来确定保乳手术(BCS)对BRCA1或BRCA2突变乳腺癌患者的疗效。材料和方法:在2006年至2017年期间，75例BRCA1或BRCA2突变的乳腺癌患者接受了BCS或乳房切除术。分析了乳房手术和临床病理特征对手术结果、LR率和生存率的影响，并显示了BRCA1和BRCA2种系突变的分布。结果:患者中位年龄42岁(20 ~ 77岁)。46例(61.3%)患者发现BRCA1突变，29例(38.7%)患者发现BRCA2突变。与BRCA2携带者相比，BRCA1携带者更有可能具有更高的肿瘤分级(84.8% vs 44.8%;P = 0.001)和非腔内亚型肿瘤(67.4% vs 13.8%;P = 0.001)。44例(58.7%)患者行单侧乳房切除术，31例(41.3%)患者行BCS。中位随访时间为60(12-240)个月，平均分为BCS组和乳房切除术组的6例患者观察到LR。与乳房切除术相比，BCS后的LR率略高(分别为9.7%和6.8%)。此外，与乳房切除术组相比，BCS组10年后无病生存(DFS)和疾病特异性生存(DSS)率无统计学意义差异(p分别= 0.117和0.109)，但事实上，BCS组的比率更好。结论:我们的研究结果表明，对于BRCA1或BRCA2突变的乳腺癌患者，BCS可能是乳房切除术的有效替代方法。此外，肿瘤大小、淋巴结阳性和TNM分期也应考虑在内，以便更好地做出手术决策。
Is Breast Conserving Surgery Efficacious in Breast Cancer Patients with BRCA1 or BRCA2 Germline Mutation?
Background: The optimal surgical therapy for newly diagnosed breast cancer with germline mutations in susceptibility genes is still uncertain for many physicians. In this study, we aimed to determine the efficacy of breast conserving surgery (BCS) in breast cancer patients with BRCA1 or BRCA2 mutation by assessing its outcomes and locoregional recurrence (LR) rates.
Materials and methods: Seventy-five patients operated with BCS or mastectomy for breast cancer between 2006 and 2017 and had BRCA1 or BRCA2 mutation were included in the study. Effects of the performed breast surgery and clinicopathological characteristics on surgical outcomes, LR rates and survival were analyzed with showing the distribution of BRCA1 and BRCA2 germline mutations.
Results: The median age of the patients was 42 years (20-77). BRCA1 mutations were found in 46 (61.3%) patients and BRCA2 mutations in 29 (38.7%) patients. Compared to BRCA2 carriers, BRCA1 carriers were more likely to have higher tumor grade (84.8% vs 44.8%; p = 0.001) and non-luminal subtype tumors (67.4% vs 13.8%; p = 0.001). A total of 44 (58.7%) patients underwent unilateral mastectomy and 31 (41.3%) patients underwent BCS. At a median follow-up time of 60 (12-240) months, LR was observed in 6 patients equally divided in both BCS and mastectomy groups. LR rates were slightly higher after BCS versus mastectomy (9.7% and 6.8%, respectively). Additionally, there were no statistically significant differences in disease-free survival (DFS) and disease-specific survival (DSS) rates after 10 years in the BCS group versus the mastectomy group (p = 0.117 and 0.109, respectively), but in fact, the rates were better in the BCS group.
Conclusion: Our findings indicate that BCS may serve as an efficacious alternative to mastectomy for breast cancer patients with BRCA1 or BRCA2 mutation. Additionally, tumor size, lymph node positivity, and TNM stage should be taken into consideration for a better surgical decision-making.
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