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Title: Pathology of breast and ovarian cancers among BRCA1 and BRCA2 mutation carriers: results from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA).
Authors: Mavaddat N,  Barrowdale D,  Andrulis IL,  Domchek SM,  Eccles D,  Nevanlinna H,  Ramus SJ,  Spurdle A,  Robson M,  Sherman M,  Mulligan AM,  Couch FJ,  Engel C,  McGuffog L,  Healey S,  Sinilnikova OM,  Southey MC,  Terry MB,  Goldgar D,  O'Malley F,  John EM,  Janavicius R,  Tihomirova L,  Hansen TV,  Nielsen FC,  Osorio A,  Stavropoulou A,  Benítez J,  Manoukian S,  Peissel B,  Barile M,  Volorio S,  Pasini B,  Dolcetti R,  Putignano AL,  Ottini L,  Radice P,  Hamann U,  Rashid MU,  Hogervorst FB,  Kriege M,  van der Luijt RB,  HEBON,  Peock S,  Frost D,  Evans DG,  Brewer C,  Walker L,  Rogers MT,  Side LE,  Houghton C,  EMBRACE,  Weaver J,  Godwin AK,  Schmutzler RK,  Wappenschmidt B,  Meindl A,  Kast K,  Arnold N,  Niederacher D,  Sutter C,  Deissler H,  Gadzicki D,  Preisler-Adams S,  Varon-Mateeva R,  Schönbuchner I,  Gevensleben H,  Stoppa-Lyonnet D,  Belotti M,  Barjhoux L,  GEMO Study Collaborators,  Isaacs C,  Peshkin BN,  Caldes T,  de la Hoya M,  Cañadas C,  Heikkinen T,  Heikkilä P,  Aittomäki K,  Blanco I,  Lazaro C,  Brunet J,  Agnarsson BA,  Arason A,  Barkardottir RB,  Dumont M,  Simard J,  Montagna M,  Agata S,  D'Andrea E,  Yan M,  Fox S,  kConFab Investigators,  Rebbeck TR,  Rubinstein W,  Tung N,  Garber JE,  Wang X,  Fredericksen Z,  Pankratz VS,  Lindor NM,  Szabo C,  Offit K,  Sakr R,  Gaudet MM,  Singer CF,  Tea MK,  Rappaport C,  Mai PL,  Greene MH,  Sokolenko A,  Imyanitov E,  Toland AE,  Senter L,  Sweet K,  Thomassen M,  Gerdes AM,  Kruse T,  Caligo M,  Aretini P,  Rantala J,  von Wachenfeld A,  Henriksson K,  SWE-BRCA Collaborators,  Steele L,  Neuhausen SL,  Nussbaum R,  Beattie M,  Odunsi K,  Sucheston L,  Gayther SA,  Nathanson K,  Gross J,  Walsh C,  Karlan B,  Chenevix-Trench G,  Easton DF,  Antoniou AC,  Consortium of Investigators of Modifiers of BRCA1/2
Journal: Cancer Epidemiol Biomarkers Prev
Date: 2012 Jan
Branches: CGB, HREB
PubMed ID: 22144499
PMC ID: PMC3272407
Abstract: BACKGROUND: Previously, small studies have found that BRCA1 and BRCA2 breast tumors differ in their pathology. Analysis of larger datasets of mutation carriers should allow further tumor characterization. METHODS: We used data from 4,325 BRCA1 and 2,568 BRCA2 mutation carriers to analyze the pathology of invasive breast, ovarian, and contralateral breast cancers. RESULTS: There was strong evidence that the proportion of estrogen receptor (ER)-negative breast tumors decreased with age at diagnosis among BRCA1 (P-trend = 1.2 × 10(-5)), but increased with age at diagnosis among BRCA2, carriers (P-trend = 6.8 × 10(-6)). The proportion of triple-negative tumors decreased with age at diagnosis in BRCA1 carriers but increased with age at diagnosis of BRCA2 carriers. In both BRCA1 and BRCA2 carriers, ER-negative tumors were of higher histologic grade than ER-positive tumors (grade 3 vs. grade 1; P = 1.2 × 10(-13) for BRCA1 and P = 0.001 for BRCA2). ER and progesterone receptor (PR) expression were independently associated with mutation carrier status [ER-positive odds ratio (OR) for BRCA2 = 9.4, 95% CI: 7.0-12.6 and PR-positive OR = 1.7, 95% CI: 1.3-2.3, under joint analysis]. Lobular tumors were more likely to be BRCA2-related (OR for BRCA2 = 3.3, 95% CI: 2.4-4.4; P = 4.4 × 10(-14)), and medullary tumors BRCA1-related (OR for BRCA2 = 0.25, 95% CI: 0.18-0.35; P = 2.3 × 10(-15)). ER-status of the first breast cancer was predictive of ER-status of asynchronous contralateral breast cancer (P = 0.0004 for BRCA1; P = 0.002 for BRCA2). There were no significant differences in ovarian cancer morphology between BRCA1 and BRCA2 carriers (serous: 67%; mucinous: 1%; endometrioid: 12%; clear-cell: 2%). CONCLUSIONS/IMPACT: Pathologic characteristics of BRCA1 and BRCA2 tumors may be useful for improving risk-prediction algorithms and informing clinical strategies for screening and prophylaxis.