Radiation safe and effective for treating breast cancer patients with BRCA1 or BRCA2 mutations

September 28, 2000

To answer concerns of patients and physicians, researchers in the U.S. and Canada examined whether radiation therapy could be safely delivered to women with early stage breast cancer and BRCA1 or BRCA2 genetic mutations - and found that it can.

Some women with these mutations reject radiation therapy in favor of more radical treatments such as mastectomy, because of concerns of the effects of radiotherapy in women who carry a mutation and also of the outcome following treatment. "Since radiation is known to cause DNA damage, the concern was that the presence of a BRCA1 or BRCA2 breast cancer susceptibility gene would result in a greater sensitivity to injury from radiation," says lead investigator Lori Pierce, M.D., a radiation oncologist at the University of Michigan School of Medicine. "This study shows that radiation is both safe and effective for treating early stage breast cancer, and the findings should help allay patients' concerns. That's really good news."

The most common treatment for women with stage I/II breast cancer is breast-conserving therapy (BCT), which is a lumpectomy to remove a tumor followed by radiation to prevent recurrence.

The study compared 71 women with BRCA1 or BRCA2 mutations to 213 women with sporadic (non-hereditary) breast cancer. Women in both groups had stage I or II breast cancer and all received BCT. Five years after treatment, the researchers found no differences between the two groups in side effects after radiotherapy or in survival and the rate of cancer recurrence in the treated breast.

These early findings demonstrate that radiation therapy helps prevent cancer recurrence in early-stage breast cancer regardless of whether a woman has a BRCA1 or BRCA2 mutation. However, as the researchers expected, women with BRCA1 or BRCA2 mutations were almost 20% more likely to eventually develop cancer in their unaffected breast, compared to women with sporadic breast tumors. "That means women with breast cancer and germ-line mutations should discuss with their physicians ways to treat the existing cancer as well as prevent cancer in the opposite breast," says Dr. Pierce.
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"Effect of Radiotherapy After Breast-Conserving Treatment in Women With Breast Cancer and Germline BRCA1/2 Mutations;" Lori J. Pierce, MD, et al.; Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, MI. Vol. 18, No. 19, (October), 2000: pp 3360-3369.

The Journal of Clinical Oncology is the monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world's leading professional society representing physicians who treat people with cancer. Attribution to the Journal of Clinical Oncology is requested in all news coverage. For the Full Text of Any JCO Article, Contact 703-299-1016 or 212-584-5034.

American Society of Clinical Oncology

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