Analysis of clinical features of ovarian cancer (OC) and breast cancer (BC) among BRCA-mutated (BRCA+) and sporadic (NH) double tumors.

Abstract

e12037 Background: Women BRCA+ are at significant risk of developing both OC and BC. Double tumors could arise also in NH patients. Whether the clinical outcome of double OC and BC is different in BRCA+ and in NH subjects is unknown. Methods: The databases of the Istituto Oncologico Veneto (IOV), Medical Oncology Department of Mirano (VE) and Thiene (VI) were searched to identify the clinical and pathological features of (BC) and (OC) arisen in BRCA+ subjects as well as patients with both malignancy but tested negative/no-tested/unknown for BRCA1/2 mutation (NH). The primary endpoint was to establish if OC instead of BC needs a more intensive follow-up because it principally affects patient’s prognosis. Patients were censored at last follow-up or death (any cause) for determination of overall survival (OS). OS estimates were determined using the Kaplan-Meier method and compared by means of log-rank test. The Fisher’s exact test and the t-test were used to compare frequencies and means between groups, respectively. Results: 24/31 (77%) BRCA+ and 30/49 (61%) NH had BC as their first malignancy (p=0.15). Among NH, 20 were BRCA test negative, 20 were untested and 9 unknown. BRCA+ were younger than NH at diagnosis of first malignancy (mean age 51 vs 56y, p=0.055). Bilateral BC was more frequent in BRCA+ than in NH (78.6% vs 28.6% p=0.001). Stage III-IV OC at diagnosis were 74% in BRCA vs 61% in NH (p=0.34). Locally advanced (stage II-III) BC was significantly more frequent in BRCA+ vs NH (75% vs 42%, p=0.03). No OS difference was observed between BRCA+ and NH subjects (P=0.99). Death for progression of ovarian cancer was observed in 11/31 (35%) in BRCA+ vs 10/49 (20%) patients in NH (p=0.19). No progression of breast cancer was reported in either groups. Conclusions: OC is the killer malignancy among patients affected by OC and BC, both in BRCA+ and in NH subjects. In patients with double tumors, irrespective of their pathological features, a more conserving management for BC and an intensive follow-up for OC are suggested.