BRCA gene mutation found not to impact survival

The BRCA1 and BRCA2 genes are known to significantly increase the chances of a woman developing cancer and it was assumed that the disease in these women would be more aggressive; research from the University of Southampton has contradicted this judgement, finding that there is no different in survival rates between women with breast cancer with or without the BRCA mutations.

The study is of some significance as women are often recommended to have ‘risk reduction’ surgery after treatment for breast cancer is completed. This can involve a mastectomy, alongside the removal of ovaries and fallopian tubes to reduce the risk of recurrence.

This study does not reverse this advice but suggests that, due to survival rates being similar to women with breast cancer not exhibiting the gene mutation, there is no need to undergo the surgery immediately. It would therefore give women more time to decide whether they wanted the surgery and means women could wait until fully recovered from breast cancer treatment before undergoing the procedure.

The study involves 2,733 women and found that there was no different in overall survival two, five or 10 years after diagnosis between women with or without the BRCA mutations. After two years, survival was 97% for BRCA carriers vs 96.6% for non-carriers, after five years: 83.8% vs 85%, and after ten years: 73.4% vs 70.1%.

Professor Diana Eccles, Head of Cancer Sciences at the University of Southampton and author of the study, said: "Women diagnosed with early breast cancer who carry a BRCA mutation are often offered double mastectomies soon after their diagnosis or chemotherapy treatment, however, our findings suggest that this surgery does not have to be immediately undertaken along with the other treatment. In the longer term, risk-reducing surgery should be discussed as an option for BRCA1 mutation carriers in particular, to minimise their future risk of developing a new breast or ovarian cancer. Decisions about timing of additional surgery to reduce future cancer risks should take into account patient prognosis after their first cancer, and their personal preferences."

The BRCA mutations and risk reduction surgery received significant coverage after actor Angelina Jolie opted for pre-emptive surgery to reduce her chances of developing cancer. The study should then reduce some of the fear around being identified as a BRCA carrier.

As well as this, the study followed women who developed cancer between the years 2000 and 2008, meaning that the latest innovations in treatment were not indicated in survival figures. PARP inhibitors have since developed significant momentum in treating women with BRCA mutations, with AstraZeneca’s Lynparza, Tesaro’s Zejula and Clovis’ Rubraca amongst the drugs indicated to treat women with BRCA mutations.