Prophylactic Irradiation of the Contralateral Breast for BRCA Carriers With Early Breast Cancer: A Nonrandomized Clinical Trial
Mené sur 162 patientes atteintes d'un cancer du sein et porteuses d'une mutation de BRCA (durée médiane de suivi : 58 mois), cet essai de phase II évalue l'effet, sur le risque de cancer controlatéral, d'une radiothérapie prophylactique chez les patientes ayant refusé une mastectomie bilatérale
Women who carry germline pathogenic variants (PVs) in BRCA1/2 have a high lifetime risk of breast cancer (BC) and ovarian cancer. While breast-conserving therapy (BCT) is associated with an increased rate of ipsilateral breast tumor recurrence (IBTR) in BRCA1/2 PV carriers compared with noncarriers, life expectancy does not seem to be compromised. The risk of contralateral BC (CLT-BC) in carriers is increased, approaching 25% to 30% at 10 years. Professional societies state that BRCA PV carriers with newly diagnosed early BC (EBC) can be offered BCT and advocate discussion of bilateral risk-reducing mastectomy (RRM). Herein we report the long-term results of a prospective nonrandomized phase 2 trial (NCT00496288) of prophylactic radiation therapy (RT) to the contralateral breast in BRCA PV carriers with EBC who forego RRM. The 5-year outcome data were previously reported.
JAMA Oncology , résumé 2025