Hormone receptor status does not seem to play a role in predicting survival outcomes for young patients with invasive breast cancer who are also carriers for BRCA1 or BRCA2 pathogenic variants, according to recent research from the 2024 ASCO Annual Meeting.  

Although hormone receptor status can be prognostic and predictive for breast cancer, there is currently limited evidence on the impact of this status on clinical behavior and outcomes in young patients with BRCA pathogenic variants. 

The international cohort included 4,709 BRCA carriers at 78 hospitals with a BRCA pathogenic variant who were diagnosed with invasive breast cancer between 2000 and 2020. They examined disease-free survival (DFS), overall survival (OS), and breast cancer-specific survival for each patient based on whether they had HR-positive or negative expression as well as based on their subtype of breast cancer, comparing luminal A-like and luminal B-like breast cancer as well as triple-negative and HER2-positive breast cancer. 

In total, 2,143 patients (45.5%) with breast cancer had HR-positive disease and 2,566 (54.5%) had HR-negative disease. A subgroup of 4,363 patients had data available for breast cancer subtypes, which included 612 patients with luminal A-like, 1,038 patients with luminal B-like, 2,373 patients with triple-negative and 340 patients with HER2-positive breast cancer. 

The researchers found a significantly higher rate of distant recurrences in patients with HR-positive breast cancer compared with patients who had HR-negative disease. There was also a significantly lower rate of second primary breast cancer in patients with HR-positive disease compared with those with HR-negative disease. Among patients with HR-positive breast cancer, BRCA2 pathogenic variants were more common, and grade 3 tumors and nodal involvement were less common. 

For patients with HR-positive breast cancer, the 8-year DFS was 65.8% compared with 63.4% for patients with HR-negative disease. The researchers found no significant differences between groups regarding OS or breast cancer-specific survival, but the researchers said the hazard ratio “changed over time” for DFS, OS, and breast cancer-specific survival.  

In a subgroup analysis, the researchers noted the breast cancer subtype with the worst 8-year DFS was luminal A-like breast cancer (60.8%) followed by triple-negative (63.5%), HER2-positive (65.5%), and luminal B-like subtype breast cancer (69.7%). 

“The differences in pattern of recurrence and second primary breast cancer among hormone receptor-positive vs negative disease warrants consideration in counseling patients on treatment, follow-up strategies and indication for risk-reducing surgery.” 

-Luca Arecco, MD, medical oncology resident within the department of internal medicine and medical specialties at the University of Genoa, Italy. 

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Reference: 

https://meetings.asco.org/abstracts-presentations/233525 

Disclosures: Some authors declared financial ties to drugmakers. See full study for details. This study was supported by Associazione Italiana per la Ricerca sul Cancro. 
Disclaimer: Narration was created using Elevenlabs AI text-to-voice tools and reviewed by MD /alert editorial staff.

Photo Credit: Getty Images. 

By Jeff Craven, MD /alert Contributor