Tumor size unrelated to node status in BRCA1 carriers

Numerous reports have shown a strong positive correlation between breast tumor size and lymph node status. However, new study findings suggest that this correlation is seen only in noncarriers and BRCA2 carriers, not in BRCA1 carriers.

‘These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma,’ lead author Dr. William D. Foulkes, from Montreal General Hospital, and colleagues note.The results, which are published in the September 8th online issue of Cancer, are based on a study of 1555 women with invasive breast cancer who underwent resection of the primary tumor and had the axillary nodes evaluated.The subjects included 1143 women without a known mutation, 276 BRCA1 carriers, and 136 BRCA2 carriers. Of the women without a known mutation, 208 had been tested and 935 had not. In untested women, proven noncarriers, and BRCA2 carriers, tumor size was directly related to the risk of lymph node involvement (p < 0.0001 for each). In BRCA1 carriers, however, no clear link between tumor size and lymph node status was observed, the researchers point out.The current findings support the belief that BRCA1-related tumors are biologically distinct from BRCA2-related and nonhereditary cancers, the authors state. Further epidemiologic studies are needed 'to determine the prognostic value of tumor size, grade and lymph node status, independently and jointly, in BRCA1 carriers,' they add.(Source: Cancer 2003;September 8th online issue:000-000: Reuters Health: September 8, 2003: Oncolink)