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Lani · 07-12-2007, 05:32 AM

Genes May Not Affect Odds
Of Surviving Breast Cancer
By JOSEPH PEREIRA
July 12, 2007; Page B6
Breast-cancer patients carrying two well-known genes linked to the disease have the same survival chances as noncarriers of the genes who develop the disease, according to a study by Israeli and Canadian researchers.

The study was aimed in part at shedding light on whether breast-cancer treatment should be tailored differently for women with the two gene mutations, known as BRCA1 and BRCA2. The results provided no decisive answers on that question, but could provide some comfort to carriers who might feel the odds stacked against them.

The study of 1,545 breast-cancer patients found 10-year survival rates of 49% for women carrying BRCA1, 48% for carriers of BRCA2 and 51% for noncarriers, including deaths from other causes. The slight differences weren't statistically significant. The study was published in this week's New England Journal of Medicine.

The differences in death rates from breast cancer among the three groups also weren't statistically significant. After 10 years with the disease, about 33% of both noncarriers and carriers of the BRCA1 gene had died from it.

"As a result of the study, we can offer to the medical community the assurance that there is no difference in the prognosis between carriers and noncarriers," said Gad Rennert, the study's lead author and chairman of the medical faculty at Israel's Technion university in Haifa.

The finding is somewhat of a surprise, as carriers of the mutant genes tend to develop a more virulent form of the disease that strikes before age 50, and can be resistant to certain types of treatments. Previous studies have produced conflicting results, partly because they were conducted on a smaller scale. But researchers say that this study -- conducted by scientists at Technion and the University of Toronto -- is by far the largest of its kind, giving more weight to its conclusion.

One problem that has stymied researchers is a scarcity of patients with the condition. Less than 1% of the general female population carry the BRCA genetic mutations. But among Jewish women of Ashkenazi, or European, descent, the two mutations are especially prevalent. For the study, researchers culled their breast-cancer subjects from the Israel National Cancer Registry, gathering medical records and tumor-tissue samples from patients dating back to the late 1980s.

It remains to be seen whether the study's results will influence the treatment of patients with the mutation. Simply learning that a patient has the genes "may add little to the clinician's ability to select a therapy or predict the course of the disease," writes Patricia Hartge, a National Cancer Institute researcher who wrote an accompanying editorial. She added, however, that the finding gives women who know they have the mutation and their doctors another factor to consider as they ponder such precautionary measures as prophylactic surgery before the onset of the disease.

Dr. Hartge said one perplexing statistic in the study involves a small number of patients who died within 10 years even though their tumors were small and hadn't spread to the lymph nodes. While the overall conclusion of the study is "generally comforting," she said, "there is this little disturbing footnote that is calling for further research on the subject."

07-12-2007, 05:32 AM	#29
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	read the last line*** Genes May Not Affect Odds Of Surviving Breast Cancer By JOSEPH PEREIRA July 12, 2007; Page B6 Breast-cancer patients carrying two well-known genes linked to the disease have the same survival chances as noncarriers of the genes who develop the disease, according to a study by Israeli and Canadian researchers. The study was aimed in part at shedding light on whether breast-cancer treatment should be tailored differently for women with the two gene mutations, known as BRCA1 and BRCA2. The results provided no decisive answers on that question, but could provide some comfort to carriers who might feel the odds stacked against them. The study of 1,545 breast-cancer patients found 10-year survival rates of 49% for women carrying BRCA1, 48% for carriers of BRCA2 and 51% for noncarriers, including deaths from other causes. The slight differences weren't statistically significant. The study was published in this week's New England Journal of Medicine. The differences in death rates from breast cancer among the three groups also weren't statistically significant. After 10 years with the disease, about 33% of both noncarriers and carriers of the BRCA1 gene had died from it. "As a result of the study, we can offer to the medical community the assurance that there is no difference in the prognosis between carriers and noncarriers," said Gad Rennert, the study's lead author and chairman of the medical faculty at Israel's Technion university in Haifa. The finding is somewhat of a surprise, as carriers of the mutant genes tend to develop a more virulent form of the disease that strikes before age 50, and can be resistant to certain types of treatments. Previous studies have produced conflicting results, partly because they were conducted on a smaller scale. But researchers say that this study -- conducted by scientists at Technion and the University of Toronto -- is by far the largest of its kind, giving more weight to its conclusion. One problem that has stymied researchers is a scarcity of patients with the condition. Less than 1% of the general female population carry the BRCA genetic mutations. But among Jewish women of Ashkenazi, or European, descent, the two mutations are especially prevalent. For the study, researchers culled their breast-cancer subjects from the Israel National Cancer Registry, gathering medical records and tumor-tissue samples from patients dating back to the late 1980s. It remains to be seen whether the study's results will influence the treatment of patients with the mutation. Simply learning that a patient has the genes "may add little to the clinician's ability to select a therapy or predict the course of the disease," writes Patricia Hartge, a National Cancer Institute researcher who wrote an accompanying editorial. She added, however, that the finding gives women who know they have the mutation and their doctors another factor to consider as they ponder such precautionary measures as prophylactic surgery before the onset of the disease. Dr. Hartge said one perplexing statistic in the study involves a small number of patients who died within 10 years even though their tumors were small and hadn't spread to the lymph nodes. While the overall conclusion of the study is "generally comforting," she said, "there is this little disturbing footnote that is calling for further research on the subject."