The Risk of Ovarian Cancer After Breast Cancer in BRCA1 and BRCA2 Carriers
Bibliographic record
Abstract
This study was conducted to investigate the incidence of ovarian cancer after a primary diagnosis of breast cancer in women with the BRCA1 or BRCA2 mutation. A review of the records from the 10 participating institutions between 1975 and 2000 identified families with a documented BRCA1 or BRCA2 mutation and at least 1 case of breast cancer. Women who were older than 65 years of age, who were diagnosed before 1975, who were known not to have the mutation, and women living outside North America were not included. Of 1139 stage I or II breast cancer diagnoses in 337 families, 729 met the inclusion criteria. Of these women, 449 had sufficient information for analysis. The average age at diagnosis of breast cancer was 41.7 years (range, 24–65 years) and average follow up was 9.6 years. Forty-six (10.2%) of the 449 patients with breast cancer developed ovarian cancer (including 1 with cancer of the omentum, 2 with peritoneal cancer, and 3 with fallopian tube cancer). The mean time to development of ovarian cancer was 8.1 years (range, 0.1–25.5 years). The average age at diagnosis of was 51.7 years (range, 35–78 years). On average, women with the BRCA1 mutation were diagnosed with ovarian cancer earlier than those with the BRCA2 mutation (51.7 years vs. 54.8 years). The 5- and 10-year risks of ovarian cancer after breast cancer were 4.5% and 12.7% for women with BRCA1 mutation and 5.3% and 6.8% for women with BRCA2, respectively. After univariate and multivariate analyses of possible risk factors, including age, treatment received, time, and gene status, the only significant risk factor for the development of ovarian cancer after breast cancer was gene status. The risk for women with the BRCA2 mutation was less than half that of women with the BRCA1 mutation (odds ratio = 0.41; confidence interval = 0.19 - 0.90; P = 0.026). Eighty-three (91.5%) of the 449 women died of either breast cancer or ovarian cancer. Among the 201 women with stage I breast cancer, 21 died of breast cancer and 7 (25%) died of ovarian cancer. In the 28 patients with stage II breast cancer, there were 54 deaths from breast cancer and 1 from ovarian cancer.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".