Clinical and Pathologic Differences Between BRCA1-, BRCA2-, and Non-BRCA-Associated Breast Cancers in a Multiracial Developing Country

• Published in: World journal of surgery Vol. 33; no. 10; pp. 2077 - 2081
• Main Authors: Yip, Cheng-Har, Taib, N. A., Choo, W. Y., Rampal, S., Thong, M. K., Teo, S. H.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.10.2009; Springer‐Verlag; Springer; John Wiley & Sons, Inc
• Subjects: Abdominal Surgery; Adult; Biological and medical sciences; BRCA1 Mutation Carrier; BRCA2 Mutation; Breast Cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Cardiac Surgery; Continental Population Groups; Deleterious Mutation; Developing Countries; Female; General aspects; General Surgery; Genes, BRCA1; Genes, BRCA2; Gynecology. Andrology. Obstetrics; Humans; Malaysia; Mammary gland diseases; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Progesterone Receptor; Retrospective Studies; Surgery; Thoracic Surgery; Tumors; Vascular Surgery; Malaysia; BRCA1 Mutation Carrier; Progesterone Receptor; BRCA2 Mutation; Deleterious Mutation; Breast Cancer; Breast disease; Developing countries; Breast cancer; Malignant tumor; Medicine; Mammary gland diseases; Treatment; BRCA2 gene; Surgery; Mammary gland; BRCA1 gene; Comparative study; Cancer; Tumor suppressor gene
• ISSN: 0364-2313; 1432-2323; 1432-2323
• DOI: 10.1007/s00268-009-0146-8

Background Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1- and BRCA2 -associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pathologic features and clinical features differ in patients with and without BRCA mutations in this Asian population. Methods We conducted a retrospective review of the medical records of 152 women with breast cancer who underwent genetic testing for BRCA mutations. The patients self-reported ethnicity, age at onset, and clinical stage at diagnosis and tumor pathology were reviewed. Results A total of 31 patients carried germline deleterious mutations (16 BRCA1 , 15 BRCA2 ). We found that tumors in BRCA1 carriers were more likely to be estrogen receptor (ER)-negative and progesterone receptor (PR)-negative. HER2 was more likely to be negative in both BRCA1 and BRCA2 subjects compared with non-BRCA subjects. We found a strong association between triple-negative status and BRCA1 carriers. In addition, tumors in BRCA1 carriers were more likely to be higher grade than those in BRCA2 and non- BRCA carriers; but the difference was not statistically significant. Conclusions These results suggest that tumors associated with BRCA1 mutations are distinct from those of BRCA2 -associated and non-BRCA-associated breast cancers, and that the tumors associated with BRCA2 mutations are similar to the non- BRCA -associated breast cancers. Further studies are required to determine if the prognosis is different in each of these groups and the best management strategy for each group.