Breast Cancer Research and Treatment

, Volume 144, Issue 3, pp 443–455 | Cite as

Surgical management of breast cancer in BRCA-mutation carriers: a systematic review and meta-analysis

  • Antonis Valachis
  • Andreas D. Nearchou
  • Pehr Lind


This meta-analysis investigates the oncological safety of breast-conserving therapy BCT in BRCA-mutation carriers and the risk for contralateral breast cancer (CBC) compared with non-carriers, potential risk factors for ipsilateral breast recurrence (IBR) or CBC and grades these factors based on the level of evidence. A PubMed search was conducted through April 2013 to identify studies that described the risk for IBR and CBC after BCT in BRCA-mutation carriers versus non-carriers as well as studies that investigated risk factors for IBR and CBC in BRCA-mutation carriers. Results were summarized using meta-analysis when sufficient studies were available. Ten studies investigated the oncological safety of BCT in BRCA-mutation carriers versus non-carriers. There was no significant difference in IBR between carriers and controls (RR 1.45, 95 % CI 0.98–2.14). However, a significant higher risk for IBR in BRCA-mutation carriers was observed in studies with a median follow-up ≥7 years (RR 1.51, 95 % CI 1.15–1.98). CBCs were significantly greater in carriers versus controls (RR 3.56, 95 % CI 2.50–5.08). Use of adjuvant chemotherapy and oophorectomy were associated with a significantly lower risk for IBR in BRCA-mutation carriers. Three factors were associated with a lower risk for CBC in BRCA-mutation carriers: oophorectomy, use of tamoxifen, and age at first breast cancer. Based on current evidence, the use of BCT in BRCA-mutation carriers can be considered a reasonable option since it does not seem to increase the risk for IBR. However, several aspects should be taken into account before the final decision-making.


BRCA Breast cancer Breast-conserving therapy Meta-analysis 



This study has been funded by the Centre for Clinical Research Sörmland, Uppsala University.

Conflict of interest

The authors have no conflict of interest to declare.

Supplementary material

10549_2014_2890_MOESM1_ESM.doc (29 kb)
Supplementary material 1 (DOC 29 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Antonis Valachis
    • 1
    • 2
  • Andreas D. Nearchou
    • 1
  • Pehr Lind
    • 1
    • 3
  1. 1.Department of OncologyEskilstunaSweden
  2. 2.Centre for Clinical Research SörmlandUppsala UniversityUppsalaSweden
  3. 3.Karolinska InstituteStockholmSweden

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