Breast cancer risk after age 60 among BRCA1 and BRCA2 mutation carriers

Purpose It is not known whether the risk of breast cancer among BRCA1 and BRCA2 mutation carriers after age 60 is high enough to justify intensive screening or prophylactic surgery. Thus, we conducted a prospective analysis of breast cancer risk in BRCA1 and BRCA2 mutation carriers from age 60 until...

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Bibliographic Details
Published in:Breast cancer research and treatment 2021-06, Vol.187 (2), p.515-523
Main Authors: Stjepanovic, Neda, Lubinski, Jan, Moller, Pal, Randall Armel, Susan, Foulkes, William D., Tung, Nadine, Neuhausen, Susan L., Kotsopoulos, Joanne, Sun, Ping, Sun, Sophie, Eisen, Andrea, Narod, Steven A.
Format: Article
Language:English
Subjects:
Age
BRCA1 protein
BRCA2 protein
Breast cancer
Cancer
Cancer research
Cancer screening
Development and progression
Diagnosis
Epidemiology
Family medical history
Gene mutations
Genetic aspects
Health aspects
Hormone replacement therapy
Hormone therapy
Invasiveness
Mastectomy
Medical screening
Medicine
Medicine & Public Health
Mutation
Oncology
Oncology, Experimental
Oophorectomy
Ovariectomy
Risk factors
Surgery
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Summary:Purpose It is not known whether the risk of breast cancer among BRCA1 and BRCA2 mutation carriers after age 60 is high enough to justify intensive screening or prophylactic surgery. Thus, we conducted a prospective analysis of breast cancer risk in BRCA1 and BRCA2 mutation carriers from age 60 until age 80. Methods Subjects had no history of cancer and both breasts intact at age 60 ( n  = 699). Women were followed until a breast cancer diagnosis, prophylactic bilateral mastectomy or death. We calculated the annual cancer rate and cumulative incidence of breast cancer (invasive and in situ) from age 60 to age 80. We assessed the associations between hormone replacement therapy, family history of breast cancer and bilateral oophorectomy and breast cancer risk. Results Over a mean follow-up of 7.9 years, 61 invasive and 20 in situ breast cancers were diagnosed in the cohort. The mean annual rate of invasive breast cancer was 1.8% for BRCA1 mutation carriers and 1.7% for BRCA2 mutation carriers. The cumulative risk of invasive breast cancer from age 60 to 80 was 20.1% for women with a BRCA1 mutation and was 17.3% for women with a BRCA2 mutation. Hormone replacement therapy, family history and oophorectomy were not associated with breast cancer risk. Conclusions Findings from this large prospective study indicate that the risk of developing breast cancer remains high after age 60 in both BRCA1 and BRCA2 mutation carriers. These findings warrant further evaluation of the role of breast cancer screening in older mutation carriers.
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-020-06072-9