Rennert G et al. (2007) Clinical outcomes of breast cancer in carriers of BRCA1 and BRCA2 mutations. N Engl J Med 357: 115–123

BRCA1-associated breast cancers are characterized by features that are associated with a poor prognosis; however, the effect of BRCA1 or BRCA2 mutations on prognosis remains unclear. A recent study by Rennert et al. compared the survival rates of breast cancer patients with and without a BRCA1 or BRCA2 mutation.

The study included 2,514 women who were diagnosed with invasive breast cancer between January 1987 and December 1988 in Israel. Pathological samples and medical records were available for 1,545 patients. BRCA mutations were detected in 10% of 131 Ashkenazi Jewish women; 76 had BRCA1 mutations, 52 had BRCA2 mutations, and 3 had mutations in both genes. The 10-year survival rates were 67% for BRCA1 carriers, 56% for BRCA2 carriers and, 67% for noncarriers. The risks of breast-cancer-specific death for BRCA mutation carriers were not significantly different from those of noncarriers; using noncarriers as the reference, the adjusted hazard ratios for death from breast cancer were 0.76 for BRCA1 carriers and 1.31 for BRCA2 carriers (P = 0.31 and P = 0.28, respectively). Among those patients who did not receive chemotherapy, 10-year survival rates for BRCA1 carriers and noncarriers were similar. The 10-year survival rates for patients who received chemotherapy were 71% and 46% for BRCA1 carriers and noncarriers, respectively (P = 0.12). BRCA2 carriers had survival similar to that of noncarriers regardless of whether they received chemotherapy or not (P = 0.87 and P = 0.43, respectively).

These findings suggest that BRCA mutation status does not affect breast-cancer-related death rates in Israeli women.