Association of Genetic Testing Results with Mortality Among Women with Breast Cancer or Ovarian Cancer. Journal of the National Cancer Institute Kurian, A. W., Abrahamse, P., Bondarenko, I., Hamilton, A. S., Deapen, D., Gomez, S. L., Morrow, M., Berek, J. S., Hofer, T. P., Katz, S. J., Ward, K. C. 2021


Breast cancer and ovarian cancer patients increasingly undergo germline genetic testing. However, little is known about cancer-specific mortality among carriers of a pathogenic variant (PV) in BRCA1/2 or other genes in a population-based setting.Georgia and California Surveillance Epidemiology and End Results (SEER) registry records were linked to clinical genetic testing results. Women were included who had stages I-IV breast cancer or ovarian cancer diagnosed in 2013-2017; received chemotherapy; and linked to genetic testing results. Multivariable Cox proportional hazard models were used to examine the association of genetic results with cancer-specific mortality.22,495 breast and 4,320 ovarian cancer patients were analyzed, with a median follow-up of 41 months. PVs were present in 12.7% of breast cancer patients with estrogen and/or progesterone receptor-positive, HER2-negative cancer, 9.8% with HER2-positive cancer, 16.8% with triple-negative breast cancer and 17.2% with ovarian cancer. Among triple-negative breast cancer patients, cancer-specific mortality was lower with BRCA1 (hazard ratio [HR] = 0.49, 95% confidence interval [CI] = 0.35-0.69) and BRCA2 PVs (HR?=?0.60, 95% CI?=?0.41-0.89), and equivalent with PVs in other genes (HR?=?0.65, 95% CI?=?0.37-1.13), versus non-carriers. Among ovarian cancer patients, cancer-specific mortality was lower with PVs in BRCA2 (HR?=?0.35, 95% CI?=?0.25-0.49) and genes other than BRCA1/2 (HR?=?0.47, 95% CI?=?0.32-0.69). No PV was associated with higher cancer-specific mortality.Among breast cancer and ovarian cancer patients treated with chemotherapy in the community, BRCA1/2 and other gene PV carriers had equivalent or lower short-term cancer-specific mortality than non-carriers. These results may reassure newly diagnosed patients and longer follow-up is ongoing.

View details for DOI 10.1093/jnci/djab151

View details for PubMedID 34373918