ABSTRACT
Reports of BRCA2 genetic mutations on the prognosis of familial breast cancer (BC) patients have been contradictory. True difference in survival, if it exists, would have important implications for genetic counseling and in treatment of hereditary BC. The purpose of this study was to compare overall survival rate (OSR) among BRCA2 mutation carriers, non-carriers and sporadic BC patients. We searched the PUBMED and EMBASE databases and retrieved 4529 articles using keywords that included breast cancer, BRCA, prognosis and survival. Nine articles were selected for systematic review and among them 6 were included in our meta-analysis. We used the fixed and random effect models to calculate the summary odds ratio (OR) and corresponding 95% confidence interval (CI). BRCA2 mutation carriers had significantly higher long-term OSR than non-carriers (OR=0.69 [95% CI=0.5-0.95]), while both short-term and long-term OSR of BRCA2 mutation carriers did not differ from those of patients with sporadic disease (OR=1.11 [95% CI=0.74-1.65]; 0.85 [95% CI=0.38-1.94], respectively). For BC-specific survival rate (BCSSR), BRCA2 mutation carriers had a similar BCSSR to the non-carriers (OR=0.61 [95% CI=0.28-1.34]). There was no significant difference in disease-free survival (DFS) between BRCA2 mutation carriers and patients with sporadic disease. Our results suggest that BRCA2 mutation increases long-term OSR in hereditary BC, which reminds us a new prospect of management of the disease.
Subject(s)
Female , Humans , BRCA2 Protein , Genetics , Breast Neoplasms , Genetics , Mortality , Pathology , Gene Expression , Genetic Counseling , Genetic Predisposition to Disease , Mutation , Odds Ratio , Prognosis , Survival AnalysisABSTRACT
Paciente de género femenino de 51 años que en una revisión de rutina se observó lesión sospechosa de mama derecha, BIRADS IVa. Patología reportó cáncer ductal infiltrante moderadamente diferenciado con dos focos de carcinoma invasor separados de 2 y 1 mm, receptores de estrógeno y progesterona positivos. El cáncer de mama familiar abarca entre el 5 por ciento al 10 por ciento de cáncer de mama de la población en general. Los genes involucrados en este padecimiento son: BRCA1 en 20 por ciento, BRCA 2 en 20 por ciento, CHEK2 en 5 por ciento, TP 53 en 1 por ciento, sin embargo, en más del 50 por ciento de los casos se desconoce en gen asociado. El BRCA1 es un gen localizado en el cromosoma 17q21, supresor de tumor, involucrado en la regulación del ciclo celular, reparación del ADN dañado, mantenimiento de la estabilidad genómica y regulación de la transcripción. Existen indicaciones precisas para la búsqueda intencionada del gen BRCA en pacientes con historia familiar o personal de cßncer de mama y ovario.
51 year old female found on check up a suspicious lesion in right breast, BIRADS IVa. Pathology reported a ductal infiltrative moderately differentiated cancer with two separate carcinomas of 2 and 1 mm each, progesterone and estrogen receptors. Familiar breast cancer is calculated to be about 5-10 percent of all breast cancers. The genes involved are: BCRA1 in 20 percent, BRCA2 in 20 percent, CHEK2 in 5 percent, TP 53 in 1 percent, although more than 50 percent of cases are not associated with a gen. BRCA1 is a gene in chromosome 17q21, tumor suppressor, involved in the regulation of the cellular cycle, repair of damaged DNA, maintenance of genomic stability and regulation of transcription. Specific indications are in use for BCRA gene scouting in women with family or personal history of breast or ovary cancer.