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Master Thesis

À propos d'une série rétrospective de cancers du sein diagnostiqués auprès de patientes présentant une mutation constitutionnelle des gènes BRCA1 ou BRCA2 : traitement et suivi à long terme

Abstract : Introduction: Prophylactic measures proposed to BRCA1/2 mutation carriers are well codified and based on probability, in the course of life, of breast or ovarian cancer. Bilateral prophylactic mastectomy and oophorectomy practiced at a young age have clearly demonstrated a survival benefit and a reduced risk of breast events. However, the treatment is less obvious when a mutation is discovered during or after treatment for breast cancer. In this case, there is the question of ipsilateral recurrence risk after breast conservative treatment, contralateral breast cancer risk, the benefit of oophorectomy or contralateral mastectomy. Material and Methods: the patients are 103 BRCA1/2 mutation carriers, these patients had a unilateral non-metastatic tumor, the mutation has been demonstrated retrospectively and the assumption was made between 1993 and 2013. Results: The median follow-up is 116.8 months [107.1-41.1]. The risk of ipsilateral breast tumor recurrence and contralateral cancer after 10 years is 10.4% (95% CI: 4.8-21.9) and 32.8% (95% CI: 21.8-47.4). Univariate analyses regarding the risk of locoregional tumor and contralateral cancer do not provide information as to prognostic factor in our series. The breast cancer specific survival was 87.8% (95% CI: 77.4-93.6) after 10 years. Conclusion: Contralateral breast cancer risk is high (3%/year) for BRCA1/2 mutation carriers. Conservative treatment including radiotherapy and chemotherapy reduces the risk of local relapse. The prophylactic oophorectomy lowers the risk of contralateral cancer and local relapse, and increases specific survival. Contralateral mastectomy avoids contralateral cancer, but further studies are needed to show its impact on specific survival.
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https://dumas.ccsd.cnrs.fr/dumas-01223886
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, November 3, 2015 - 4:01:43 PM
Last modification on : Wednesday, August 23, 2017 - 4:29:01 PM
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Marie Artiguenave. À propos d'une série rétrospective de cancers du sein diagnostiqués auprès de patientes présentant une mutation constitutionnelle des gènes BRCA1 ou BRCA2 : traitement et suivi à long terme. Médecine humaine et pathologie. 2015. ⟨dumas-01223886⟩

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