High incidence of germline BRCA mutation in patients with ER low‐positive/PR low‐positive/HER‐2 neu negative tumors. Issue 19 (17th August 2015)

• Record Type: Journal Article
• Authors: Sanford, Rachel A.; Song, Juhee; Gutierrez‐Barrera, Angelica M.; Profato, Jessica; Woodson, Ashley; Litton, Jennifer Keating; Bedrosian, Isabelle; Albarracin, Constance T.; Valero, Vicente; Arun, Banu
• Is Part Of: Cancer. Volume 121:Issue 19(2015)
• Page Start: 3422
• Page End: 3427
• Publication Date: 2015-08-17
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29572
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29572-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The 2015 National Comprehensive Cancer Network guidelines recommend that genetic counseling and germline <italic>BRCA</italic> mutation testing be offered to women under age 60 with triple‐negative breast cancer (TNBC). As a result of the 2010 American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines for breast cancer, patients with breast cancers that are estrogen receptor (ER) or progesterone receptor (PR) low‐positive (1%‐9% on immunohistochemistry) are no longer strictly considered to have TNBC and may not be referred for genetic counseling. However, the incidence of <italic>BRCA</italic> mutation in patients with hormone receptor (HR) low‐positive breast cancers remains unknown, and current ASCO/CAP guidelines may result in undertesting for <italic>BRCA</italic> mutations.</p> </sec> <sec id="cncr29572-sec-0002" sec-type="section"> <title>METHODS</title> <p>A prospectively maintained research database of breast cancer patients evaluated at The University of Texas MD Anderson Cancer Center between 2004 and 2014 was reviewed; 314 patients were identified with HER2/<italic>neu</italic>–negative breast cancers expressing ER and PR <10% with known <italic>BRCA</italic> mutation status.</p> </sec> <sec id="cncr29572-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Three hundred fourteen patients had breast cancers expressing ER and PR <10%; 238 (75.8%) had HR‐negative cancers (<1% ER and PR), and 76 (24.2%) had HR–low‐positive cancers (1%‐9% ER and/or PR). Among patients with HR‐negative tumors, 86 of 238 (36.1%) had a <italic>BRCA1/2</italic> mutation, whereas in the HR–low‐positive group, 30 of 76 (39.5%) had a <italic>BRCA1/2</italic> mutation. In multivariate analysis, HR status (<1% vs 1%‐9%) was not significantly associated with <italic>BRCA1/2</italic> mutations.</p> </sec> <sec id="cncr29572-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>The incidence of <italic>BRCA1/2</italic> mutations is similar in patients with HR–low‐positive breast cancer and patients with HR‐negative breast cancer. Genetic counseling and <italic>BRCA</italic> testing should be offered to patients under age 60 who have HR–low‐positive breast cancers. <bold><italic>Cancer</italic> 2015;121:3435–43.</bold> © <italic>2015 American Cancer Society</italic>.</p> </sec> </abstract>