The good news for young women who carry the infamous BRCA1 or BRCA2 gene is that their chances of survival after conventional breast cancer treatment are the same as those who don't have the mutation.
Previous studies or meta-analyses comparing outcomes in women with BRCA1 and BRCA2 mutations and those with sporadic breast cancer have reported inconsistent effects of these mutations on patient outcomes. Besides breast cancer, these mutations have been linked to an increased risk of ovarian and prostate cancers.
Professor Diana Eccles, head of cancer sciences at the University of Southampton, said: "Our study is the largest of its kind, and our findings suggest that younger women with breast cancer who have a BRCA mutation have similar survival to women who do not carry the mutation after receiving treatment".
"In view of this, younger women with breast cancer can take time to discuss whether radical breast surgery is the right choice for them as part of a longer-term risk reducing strategy", said Fiona MacNeill, a breast surgeon at The Royal Marsden National Health System Foundation Trust in Britain, which was not involved in the study.
About 97 percent of women survived for more than two years after their diagnosis, while more than 83 percent and more than 70 percent survived for five and 10 years post-diagnosis, respectively.
"However, our findings suggest that this surgery does not have to be immediately undertaken along with the other treatment".
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A subgroup analysis of 558 patients with triple-negative breast cancer, however, did show a significant survival advantage during the first few years after diagnosis in BRCA mutation carriers.
The majority of women in the study underwent chemotherapy. The expanded approval makes olaparib the first PARP inhibitor indicated for breast cancer, in addition to being the first drug approved to treat patients with a BRCA mutation.
All the women were tested for faulty BRCA genes.
The authors note the findings do not apply to older women.
The study ended in 2008, and in the last 10 years several new treatments have been released to the market. It is also approved in the US for advanced ovarian cancer patients who have received at least three prior lines of chemo and maintenance treatment of ovarian cancer in patients who are in complete or partial response to platinum-based chemo, both BRCA-positive.
Fasching added that "these risks determine treatment, and knowing that BRCA1 or BRCA2 mutations do not result in a different prognosis might change the therapeutic approach for these risks".