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Analysis of Outcomes in Patients With BRCA1/2 Breast Cancer Mutations Treated With Accelerated Partial Breast Irradiation (APBI)

Ahmed, Faisal, MD*,†; Christos, Paul J., PhD; Singh, Prabhsimranjot, MD§; Parashar, Bhupesh, MD*; Wernicke, Alla Gabriella, MSc, MD*

American Journal of Clinical Oncology: May 2019 - Volume 42 - Issue 5 - p 446–453
doi: 10.1097/COC.0000000000000542
Original Articles: Breast

Objective: To analyze outcomes and survival for BRCA1/2+ patients treated with accelerated partial breast irradiation (APBI).

Materials and Methods: Retrospective review was performed on 341 women treated with intracavitary APBI (Mammosite or Contura) postlumpectomy from 2002 to 2013. Patients were treated to 34.0 Gy in 10 BID fractions. Of 341 treated patients, 11 (3.2%) had BRCA1/2 mutations, 5 of whom had an oophorectomy. Ipsilateral breast tumor recurrence (IBTR), contralateral breast tumor recurrence (CBTR), and breast tumor recurrence progression-free survival were analyzed using SPSS-17. BRCA1/2+ patient outcomes were compared with a general population treated cohort.

Results: Median age at diagnosis was 66 years, for BRCA1/2+ women it was 61 years. Median follow-up was 8.4 years and for BRCA1/2+ patients it was 8.8 years. IBTR for the entire cohort was 3.5%, while CBTR was 1.2%. Both IBTR and CBTR for the BRCA1/2+ group were 0%. The 5-year IBTR-free survival was 97.3% (95% confidence interval [CI]=94.9%, 98.6%), and the CBTR-free survival was 99.4% (95% CI=97.6%, 99.9%). The 5-year breast tumor recurrence-free survival was 96.7% (95% CI=94.1%, 98.2%). As no patients with BRCA1/2+ mutation died of metastatic breast cancer or recurrence during follow-up and review, overall survival could not be evaluated.

Conclusions: To date, BRCA1/2+ patients treated with APBI sustained no recurrences, or second cancers. Most patients had an ER+ status and underwent oophorectomy, which may be a protective mechanism for recurrence. This is the first outcomes report in the literature of BRCA1/2 mutations treated with APBI technique.

Departments of *Radiation Oncology

Public Health, Epidemiology and Biostatistics, Weill Medical College of Cornell University, New York, NY

Department of Radiation Oncology, Stanford Cancer Institute, Stanford University, Stanford, CA

§Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA

The authors declare no conflicts of interest.

Reprints: Alla Gabriella Wernicke, MSc, MD, Stich Radiation Oncology, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10065. E-mail:

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