BRCA1/BRCA2 Germline Mutations in Locally Recurrent Breast Cancer Patients After Lumpectomy and Radiation Therapy: Implications for Breast-Conserving Management in Patients With BRCA1/BRCA2 Mutations

Turner, Bruce; Harrold, Elizabeth V.; Matloff, Ellen; Smith, Tanya E; Gumbs, Andrew A.; Beinfield, Malcom; Ward, Benjamin D.; Skolnick, Mark H.; Glazer, Peter M.; Thomas, Alun; Haffty, Bruce G.

doi:10.1200/jco.1999.17.10.3017

Cited by 107 publications

(17 citation statements)

References 35 publications

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“…Pathological risk factors for IBTR after BCS include close or positive surgical margins [1,3,12,16], presence of extensive intraductal component (EIC) in and/or around the tumor [1,[17][18], presence of lymphovascular invasion (LVI) with or without positive axillary lymph nodes [1,3,7,16,19], histological multifocality [7,16], high histopathological grade [16], negative hormonal receptor status [7], and c-erbB2 oncogene overexpression [20]. Clinical risk factors for IBTR include tumor size [16][17], young age [2][3][18][19], and gross multicentricity [9]; however, a strong family history of breast cancer has been associated with late IBTR and whether these are true recurrences or actually new tumors is controversial [21]. Skin involvement has been reported in 3% to 22% of breast recurrences in general [6,22].…”

Section: Abstract • Background : Inflammatory Local Recurrencementioning

confidence: 99%

Predictors of Inflammatory Local Recurrence after Breast - Conserving Therapy for Breast Cancer : Matched Case-Control Study

Akoum¹,

Abdalla²,

Saade³

et al. 2015

LMJ

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Ipsilateral breast tumor recurrence (IBTR) after breastconserving surgery (BCS) and whole-breast radiation occurs in 4% to 10% of patients [1][2][3]. Late local recurrence (> 2 years) in a conserved breast can usually be treated by further surgery with curative intent and remains associated with a favorable prognosis [4][5]. Early local recurrence (< 2 years) may indicate a more aggres-sive clinicobiological behavior that heralds the appearance of distant metastases in many cases [1,[6][7]. A small but important subset of patients with local recurrence develops inflammatory local recurrence (ILR), which is associated with a distinctly poorer prognosis. An uncommon finding representing 7% to 20% of recurrences [8][9][10][11][12], sometimes referred to as "secondary" inflammatory breast cancer, ILR typically occurs within two years of BCS, exhibits clinical and pathological characteristics of of inflammatory local recurrence after breast-conserving therapy for breast cancer: Matched case-control study. J Med Liban 2015 ; 63 (4) : 171-178.Akoum R, Abdalla EK, Saade M, Awdeh A, Abi-Aad F, Bejjani N, Ghossain A, Brihi E, Audi A. Facteurs prédictifs de récidive locale inflammatoire après chirurgie conservatrice du cancer du sein : Étude comparative cas-témoins.

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Section: Abstract • Background : Inflammatory Local Recurrencementioning

confidence: 99%

Predictors of Inflammatory Local Recurrence after Breast - Conserving Therapy for Breast Cancer : Matched Case-Control Study

Akoum¹,

Abdalla²,

Saade³

et al. 2015

LMJ

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“…Turner et al published one of the first reports of ipsilateral breast tumour recurrence in patients with BRCA1 and BRCA2 mutations [29]. Using a casecontrol design, the frequency of BRCA1 and BRCA2 mutations was studied in patients who developed an ipsilateral breast recurrence.…”

Section: Breast Conservation Therapy In Brca1 and Brca2 Carriersmentioning

confidence: 99%

Safety of breast conservation therapy in BRCA1 and BRCA2 cancers

Alpert

Haffty

2004

Breast Cancer Online

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For the majority of women with early-stage breast cancer, conservative management with breast conserving surgery plus radiotherapy is widely embraced. However, in patients with germline mutations of BRCA1 and BRCA2, the safety of breast conservation therapy remains controversial. These breast cancer susceptibility genes are associated with an increased risk of second cancers, although the prognosis of BRCA1 or BRCA2 breast cancer is similar to patients with sporadic breast cancer. Preclinical evidence for radiosensitivity has prompted concern for radiation-induced complications in patients with genetic breast cancer. There is limited literature on the safety breast conservation therapy in patients with BRCA1 and BRCA2 mutations. The largest published study reported acute and chronic radiation toxicity results and noted no adverse sequelae in the genetic cohort [1]. Selected published studies demonstrate recurrence rates and overall survival comparable to sporadic controls [1–3]. A series with longer follow-up reported an increase in late second-primary breast cancers, highlighting the need for preventative strategies [4]. Tamoxifen and oophorectomy have a potential role in modifying the rate of second events, and thereby improving the safety of breast conservation therapy.

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“…One study has demonstrated an apparent increased risk of metachronous ipsilateral disease among mutation carriers surviving for a prolonged period after their initial breast cancer, apparently related to an increased risk of new primary lesions within the treated breast. 49,50 Studies with generally shorter follow-up, however, have not clearly identified a dramatically elevated risk when the influence of young age is taken into account. 28,51 The apparent contradiction may be resolved by a model wherein a breast lesion is as likely to be controlled by radiotherapy in women with BRCA mutations as in those without such mutations, but that the breast tissue of mutation carriers remains at risk for the development of new primary malignancies, which may not manifest until many years later.…”

Section: Cancer Risks In Individuals Withmentioning

confidence: 99%

Clinical Considerations in the Management of Individuals at Risk for Hereditary Breast and Ovarian Cancer

Robson

2002

Cancer Control

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BRCA1/BRCA2 Germline Mutations in Locally Recurrent Breast Cancer Patients After Lumpectomy and Radiation Therapy: Implications for Breast-Conserving Management in Patients With BRCA1/BRCA2 Mutations

Cited by 107 publications

References 35 publications

Predictors of Inflammatory Local Recurrence after Breast - Conserving Therapy for Breast Cancer : Matched Case-Control Study

Predictors of Inflammatory Local Recurrence after Breast - Conserving Therapy for Breast Cancer : Matched Case-Control Study

Safety of breast conservation therapy in BRCA1 and BRCA2 cancers

Clinical Considerations in the Management of Individuals at Risk for Hereditary Breast and Ovarian Cancer

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