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Abstract
Nowadays, BRCA-associated breast cancer occupies a special position in the choice of treatment strategy. Although, the drug treatment of such patients was almost the same as the treatment of sporadic disease. Of particular interest is the assessment of the deficit of homologous recombination, which may include various dysfunctions of the BRCA1 gene. Moreover, it has been shown that a decrease in the functional activity of BRCA1 is reflected in the sensitivity of the tumor to DNA damaging agents, and the prognosis of the disease becomes more favorable.
Aim: assessment of the association of BRCA1 gene expression in a breast tumor with the prognosis of the disease.
Materials and methods. The study included 111 patients with breast cancer T1-4N0-3M0 (stage IIA - IIIB), with a morphologically verified diagnosis. Initial and postoperative expression of BRCA1 in tumor material was evaluated. RNA was isolated from the tumor material before treatment and after NAC. The level of BRCA1 expression was assessed using reverse transcriptase quantitative real-time PCR (RT-qPCR).
Results. As a result of the study, long-term results of treatment of patients were evaluated depending on the level of BRCA1 gene expression. The presence of BRCA1 hypoexpression (level less than 1) in tumor tissue after NAC was found to be a favorable prognostic factor and is associated with high rates of metastasis-free survival (p=0.0002). In addition, a similar result is shown for patients treated with the FAC NAC regimen (p=0.005). An interesting result was demonstrated for 8 patients who underwent chemotherapy with the inclusion of platinum drugs. All patients had a low postoperative expression level of BRCA1 and 100% non-metastatic and overall survival.
Conclusion. Thus, the data obtained indicate the prognostic significance of BRCA1 gene expression in a breast tumor after neoadjuvant chemotherapy.
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