UK Study:Better Life Expectancy in Women with BRCA2 Compared with BRCA1 Mutations Is Attributable to Lower Frequency and Later Onset of Ovarian Cancer

The following article is from http://www.ncbi.nlm.nih.gov/pubmed/18559571?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

I wonder if other studies have been done with larger numbers and what the results have been. The study mentions that this is "the first formal assessment of life expectancy in women with BRCA1 and BRCA2 mutations in these genes".

Cancer Epidemiol Biomarkers Prev. 2008 Jun;17(6):1535-42.

Links Better Life Expectancy in Women with BRCA2 Compared with BRCA1 Mutations Is Attributable to Lower Frequency and Later Onset of Ovarian Cancer.

Byrd LM, Shenton A, Maher ER, Woodward E, Belk R, Lim C, Lalloo F, Howell A, Jayson GC, Evans GD. St. Mary's Hospital, Hathersage Road, Whitworth Park, Manchester M13 0JH, United Kingdom. Louise.Byrd@cmmc.nhs.uk.

PURPOSE: No formal assessment of life expectancy in women with BRCA1 and BRCA2 mutations in these genes has been reported previously. We have evaluated life expectancy using actuarial analysis and assessed the effect of breast and ovarian cancers on premature death in >1,000 BRCA1/2 carriers.

METHODS: Families with pathogenic mutations in BRCA1 and BRCA2 have been ascertained in a 10-million population region of United Kingdom since 1996. Mutation carriers and their first-degree relatives were used in an analysis of breast and ovarian cancer incidence and mortality as well as to derive and compare an actuarial assessment of life expectancy.

RESULTS: Six hundred twelve BRCA1 and 482 BRCA2 female mutation carriers were identified from 482 families. Life expectancy was significantly reduced for BRCA1 carriers compared with BRCA2 (P = 0.0002). This effect was attributable to an increased death rate from ovarian cancer (P = 0.04). Kaplan-Meier analysis revealed a better long-term survival from early-stage ovarian cancer in BRCA2 carriers but no significant differences in deaths from breast cancer or from women presenting with late-stage ovarian cancer. There was no other major contributing cause to death other than breast/ovarian cancer in BRCA1/2 female carriers.

CONCLUSION: Interventions to reduce ovarian cancer incidence are likely to have a greater effect on life expectancy in BRCA1 compared with BRCA2 carriers. (Cancer Epidemiol Biomarkers Prev 2008;17(6):1535-42).

I'M OUTRAGED!!!

This was all over news feeds this morning...I am absolutely INFURIATED!!!!!!

Stacey Fearnall, a waitress in Owen Sound, ON, who raised over $2,700.00 for shaving her head for Cops for Cancer has lost her job for being bald!!! What if she was undergoing chemotherapy or radiation treatments and lost her hair, would she receive the same treatment and be fired? The owner, Dan Hilliard, of Nathaniel's Restuarant located at 215 8th Street East in Owen Sound, ON, says this is an employer-employee matter and not a public matter. The owner is quoted in the Toronto Star as saying that "his customers would have been appalled by her shorn head". WTF!?!?!? I call BS!!!! I think Stacey's new do looks beautiful; and her ex-employer looks like a complete idiot!!! When I shaved my head last year when my mom was undergoing her chemotherapy treatments, I received nothing but praise and support from my employer. This is an outrage!

Talk about a human rights violation let alone an Ontario Labour Code wrongful dismissal. For the record, there are male waiters at this restaurant who are bald and / or shave their heads!!!! I hope she sues the pants off him for discrimination and wrongful dismissal!

I for one will NEVER EVER set foot anywhere near this man's restaurant.

CBC News - Waitress loses job after shaving head for cancer charity

CTV News - Woman fired after shaving head for cancer charity

Toronto Star - Waitress laid off after shaving head for cancer

MacLeans - Owen Sound, Ont., waitress laid off after shaving head for cancer charity

Yahoo News - Waitress loses job after shaving head for cancer charity

Sympatico MSN News - Waitress loses job after shaving head for cancer charity

Do a search on google...this has hit the news across the entire country; people are outraged!

ANNUAL ULTRASOUND/CA125 - DOES NOT INCREASE OVARIAN CANCER SURVIVAL

Not that I ever doubted I was making the right decision having prophylactic surgery, this seals the deal for me. I'm even more confident and content in my decision.

The following is from http://www.ncbi.nlm.nih.gov/sites/entrez/, a service of the U.S. National Library of Medicine and the National Institutes of Health

Screening for Familial Ovarian Cancer: Poor survival of BRCA1/2 related cancers.

Gareth R Evans, Katja N Gaarenstroom, Diane stirling, Andrew Shenton, lovise Maehle, Ann Dørum, Michael Steel, Fiona Lalloo, Jaran Apold, Mary Porteous8, Hans F.A. Vasen, Christi van Asperen and Pal Moller

1. St Mary's Manchester, United Kingdom
2. Leiden University Medical Center, Netherlands
3. Western General Hospital, United Kingdom
4. Rikshospitalet Radiumhospitalet, Norway
5. University of St Andrews, United Kingdom
6. St Marys Hospital, Manchester, United Kingdom
7. Haukeland University Hospital, Norway
8. SE Scotlang Genetic Service, United Kingdom
9. Netherlands Foundation for the Detection of Hereditary Tumours, Netherlands

Abstract Purpose: To assess the effectiveness of annual ovarian cancer screening (transvaginal ultrasound and serum CA125 estimation) in reducing mortality from ovarian cancer in women at increased genetic risk.

Patients and methods: A cohort of 3532 women at increased risk of ovarian cancer was screened at five European centres between January 1991 and March 2007. Survival from diagnosis of ovarian cancer was calculated using Kaplan-Meier analysis and compared for proven BRCA1/2 carriers with non-carriers and whether the cancer was detected at prevalence or post prevalent scan. Screening was performed by annual transvaginal ultrasound and serum CA125 measurement.

Results: 64 epithelial ovarian malignancies (59 invasive and 5 borderline), developed in the cohort. 26 tumours were detected at prevalent round, there were 27 incident detected cancers and 11 interval. Sixty-five percent of cancers were stage 3 or 4, however, stage and survival were little different for prevalent versus post prevalent cancers. Five year and 10-year survival in 49 BRCA1/2 mutation carriers was 58.6% (95% CI 50.9-66.3%) and 36% (95% CI 27-45%), which was significantly worse than for 15 non BRCA-carriers (91.8% (95% CI 84-99.6%) both 5 and 10-year survival p=0.015). However, when borderline tumours were excluded, the difference in survival between carriers and non-carriers was no longer significant.

Conclusion: Annual surveillance, by trans-vaginal ultrasound scanning and serum CA125 measurement in women at increased familial risk of ovarian cancer is ineffective in detecting tumours at a sufficiently early stage to substantially influence survival in BRCA1/2 carriers.