Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-10T21:19:53.916Z Has data issue: false hasContentIssue false
  • English
  • Français

Breast conservation surgery and radiation for a patient with synchronous primary breast cancers and BRCA1/BRCA2 positivity: is mastectomy required?

Published online by Cambridge University Press:  18 March 2011

Mark Trombetta ,
Katherine Kotinsley  and
Thomas B. Julian
Mark Trombetta*
Affiliation:
Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA Drexel University College of Medicine, Department of Radiation Oncology, Allegheny Campus, Pittsburgh, Pennsylvania, USA
Katherine Kotinsley
Affiliation:
Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
Thomas B. Julian
Affiliation:
Department of Human Oncology; Allegheny General Hospital, Pittsburgh, Pennsylvania, USA Drexel University College of Medicine, Department of Surgery, Allegheny Campus, Pittsburgh, Pennsylvania, USA
*
Correspondence to: Mark Trombetta, Department of Radiation Oncology, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, Pennsylvania 15212, USA. E-mail: mtrombet@wpahs.org
Get access Rights & Permissions [Opens in a new window]

Abstract

The role of breast conservation in patients expressing BRCA1 and BRCA2 genetic mutations is controversial. A patient who was found to have bilateral synchronous breast cancers and expressed a BRCA genetic mutation was recently evaluated. The patient had a strong desire for breast preservation. This case and a review of the pertinent literature are presented to discuss the role of breast conservation and radiation in patients with BRCA1 or BRCA2 genetic mutations.

Keywords

BRCA1BRCA2RadiationMastectomyBreast Conservation
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 11 , Issue 1 , March 2012 , pp. 62 - 65
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pierce, LJ, Levin, AM, Rebbeck, TR, Ben-David, MA, Friedman, E, Solin, LJ, Harris, EE, Gaffney, DK, Haffty, BG, Dawson, LA, Narod, SA, Olivotto, IA, Eisen, A, Whelan, TJ, Olopade, OI, Isaacs, C, Merajver, SD, Wong, JS, Garber, JE, Weber, BL. Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1/2-associated stage I/II breast cancer. J Clin Oncol 2006; 24:2437–2443.CrossRefGoogle ScholarPubMed
Heemskerk-Gerritsen, BA, Brekelmans, C, Menke-Pluymers, MB, van Geel, AN, Tilanus-Linthorst, MMA, Bartels, CCM, Tan, M, Meijers-Heijboer, HEJ, Klijn, JGM, Seynaeve, C. Prophylactic mastectomy in BRCA1/2 mutation carriers and women at risk of hereditary breast cancer: long term experiences at the Rotterdam Family Cancer Clinic. Ann Surg Oncol 2007, 14:3335–3344.CrossRefGoogle ScholarPubMed
Ganz, PA, Schag, AC, Lee, JJ, Polinsky, ML, Tan, SJ. Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery? Cancer 1992; 69:1729–1738.Google Scholar
Maunsell, E, Brisson, J, Deschenes, L. Psychological distress after initial treatment for breast cancer: a comparison of partial and total mastectomy. J Clin Epidemiol 1989; 42:765–771.Google Scholar
Pierce, L, Phillips, K, Griffith, L, Buys, S, Gaffney, D, Moran, M, Haffty, B, Ben-David, MKB, Garber, J, Merajver, S, Balmaña, J, Meirovitz, A, Domchek, S. Local therapy options in BRCA1/2 carriers with operable breast cancer: the importance of adjuvant chemotherapy. European Breast Cancer Conference, Barcelona, Spain 2010; Abstract 7N.CrossRefGoogle Scholar
Kirova, YM, Savignoni, A, Sigal-Zafrani, B, de La Rochefordiere, A, Salmon, RJ, This, P, Asselain, B, Stoppa-Lyonnet, D, Fourquet, A. Is the breast-conserving treatment with radiotherapy appropriate in BRCA1/2 mutation carriers? Long-term results and review of the literature. Breast Cancer Res Treat 2010; 120:119–126.Google Scholar
Pierce, LJ, Levin, AM, Rebbeck, TR, Ben-David, MA, Friedman, E, Solin, LJ, Harris, EE, Gaffney, DK, Haffty, BG, Dawson, LA, Narod, SA, Olivotto, IA, Eisen, A, Whelan, TJ, Olopade, OI, Isaacs, C, Merajver, SD, Wong, JS, Garber, JE, Weber, BL. Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1/2-associated stage I/II breast cancer. J Clin Oncol 2006;24:2437–2443.CrossRefGoogle ScholarPubMed
Turner, BC, Harrold, E, Matloff, E, Smith, T, Gumbs, AA, Beinfield, M, Ward, B, Skolnick, M, Glazer, PM, Thomas, A, Haffty, BG. BRCA1/BRCA2 germline mutations in locally recurrent breast cancer patients after lumpectomy and radiation therapy: implications for breast-conserving management in patients with BRCA1/BRCA2 mutations. J Clin Oncol 1999; 17:3017–3024.Google Scholar
Warner, E, Plewes, DB, Hill, KA, Causer, PA, Zubovits, JT, Jong, RA, Cutrara, MR, DeBoer, G, Yaffe, MJ, Messner, SJ, Meschino, WS, Piron, CA, Narod, SA. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA 2004; 292:1317–1325.Google Scholar
Verhoog, LC, Brekelmans, CT, Seynaeve, C, van den Bosch, LM, Dahmen, G, van Geel, AN, Tilanus-Linthorst, MM, Bartels, CC, Wagner, A, van den Ouweland, A, Devilee, P, Meijers-Heijboer, EJ, Klijn, JG. Survival and tumour characteristics of breast-cancer patients with germline mutations of BRCA1. Lancet 1998; 351:316–321.Google Scholar
Robson, ME, Chappuis, PO, Satagopan, J, Wong, N, Boyd, J, Goffin, JR, Hudis, C, Roberge, D, Norton, L, Bégin, LR, Offit, K, Foulkes, WD. A combined analysis of outcome following breast cancer: differences in survival based on BRCA1/BRCA2 mutation status and administration of adjuvant treatment. Breast Cancer Res 2004; 6:R8–R17.Google Scholar
Baeyens, A, Thierens, H, Claes, K, Poppe, B, Messiaen, L, De Ridder, L, Vral, A. Chromosomal radiosensitivity in breast cancer patients with a known or putative genetic predisposition. Br J Cancer 2002; 87:1379–1385.CrossRefGoogle ScholarPubMed
Fourquet, A, Stoppa-Lyonnet, D, Kirova, YM, Sigal-Zafrani, B, Asselain, B; Institut Curie Breast Cancer Study Group; Institut Curie Breast Ovary Cancer Risk Study Group. Familial breast cancer: clinical response to induction chemotherapy or radiotherapy related to BRCA1/2 mutations status. Am J Clin Oncol 2009; 32:127–131.CrossRefGoogle ScholarPubMed
Heemskerk-Gerritsen, B, Hooning, M, Jager, A, Tilanus-Linthorst, M, Bartels, C, van den Ouweland, A, Collée, JM, Menke-Pluimers, M, Seynaeve, C. Is risk reducing mastectomy in BRCA1/2 mutation carriers with a history of unilateral breast cancer beneficial with respect to distant disease free survival and overall survival? European Breast Cancer Conference, Barcelona, Spain 2010; Abstract 500.Google Scholar