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Contralateral risk-reducing mastectomy in BRCA1 and BRCA2 mutation carriers and other high-risk women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab)

  • Epidemiology
  • Published:
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An Erratum to this article was published on 04 September 2009

Abstract

The purpose of this study is to determine the prevalence and predictors of contralateral risk-reducing mastectomy (CRRM) in Australasian women at high familial risk of a second primary breast cancer (BC). Participants were women with unilateral BC and a strong family history of the disease, including BRCA1/2 mutation carriers. Data were collected through interview, self-administered questionnaire and review of pathology and surgical reports. Associations between CRRM and potential predictors were assessed using multivariate logistic regression. Of 1,018 women (median follow-up 11.1 years), 154 (15%) underwent CRRM, 43% of these within 12 months of initial BC surgery. More likely to undergo CRRM were women who were younger at BC diagnosis (odds ratio [OR] = 0.94 per year of age, P < 0.001), were diagnosed more recently (OR = 1.16 per calendar year, P < 0.001), underwent mastectomy as initial definitive BC treatment (OR = 5.2, P < 0.001) and underwent risk-reducing salpingo-oophorectomy (OR = 3.4, P < 0.001). BRCA1/2 mutation status, axillary nodal status and receipt of chemotherapy were not independently associated with CRRM uptake. A contralateral BC event (invasive or in situ) occurred in 177 (20.5%) of the 864 women who did not have CRRM, compared with one chest wall event (0.6%) in the 154 women post-CRRM. The contralateral event rate was 15.1 per 1,000 women-years for non-CRRM women and 0.7 per 1,000 women-years for CRRM women; P < 0.0001. Younger women with more recently diagnosed BC treated with mastectomy are more likely to elect CRRM. Neither BRCA1/2 mutation status, nor the competing risk of BC recurrence and death, appears to influence decision making.

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Acknowledgments

We thank Heather Thorne, Eveline Niedermayr, the kConFab staff and staff of the Family Cancer Clinics for their contributions to this resource, as well as the many families who contribute to kConFab. We thank Lucy Burnham for expert data management.

Research support

This study was funded by the National Health and Medical Research Council (NHMRC) of Australia (#145684, 288704, 454508). KA Phillips is the Cancer Council Victoria Dr John Colebatch Clinical Research Fellow. JL Hopper is an Australia Fellow of the NHMRC and Victorian Breast Cancer Research Consortium Group Leader. kConFab is supported by grants from the National Breast Cancer Foundation, the National Health and Medical Research Council of Australia, the Queensland Cancer Fund, the Cancer Councils of New South Wales, Victoria, Tasmania and South Australia, the Cancer Foundation of Western Australia, Perpetual Philanthropic Foundations of New South Wales and the Breast Cancer Research Association.

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Authors and Affiliations

  1. Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, Melbourne, VIC, 8006, Australia

    Belinda E. Kiely, Joanne M. McKinley, Prue Weideman & Kelly-Anne Phillips

  2. Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, The University of Melbourne, Melbourne, VIC, Australia

    Mark A. Jenkins, Roger L. Milne, John L. Hopper & Kelly-Anne Phillips

  3. Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia

    Michael L. Friedlander

  4. Genetic and Molecular Epidemiology Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain

    Roger L. Milne

  5. Department of Medical Oncology, St Vincent’s Hospital, Fitzroy, VIC, Australia

    Sue-Anne McLachlan

  6. Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia

    Sue-Anne McLachlan & Kelly-Anne Phillips

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  1. Belinda E. Kiely
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  2. Mark A. Jenkins
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  4. Michael L. Friedlander
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  5. Prue Weideman
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  7. Sue-Anne McLachlan
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  8. John L. Hopper
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  9. Kelly-Anne Phillips
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Correspondence to Kelly-Anne Phillips.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s10549-009-0528-5

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Kiely, B.E., Jenkins, M.A., McKinley, J.M. et al. Contralateral risk-reducing mastectomy in BRCA1 and BRCA2 mutation carriers and other high-risk women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab). Breast Cancer Res Treat 120, 715–723 (2010). https://doi.org/10.1007/s10549-009-0497-8

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