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Evans DG, Morgan RD, Crosbie EJ, Howell SJ, Forde C, Howell A, Lalloo F, Woodward ER. Breast cancer after ovarian cancer in BRCA1 and BRCA2 pathogenic variant heterozygotes: Lower rates for 5 years post chemotherapy. Genet Med 2024; 26:101172. [PMID: 38847192 DOI: 10.1016/j.gim.2024.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 07/06/2024] Open
Abstract
PURPOSE The identification of germline BRCA1/BRCA2 pathogenic variants (PV) infer high remaining lifetime breast/ovarian cancer risks, but there is paucity of studies assessing breast cancer risk after ovarian cancer diagnosis. METHODS We reviewed the history of breast cancer in 895 PV heterozygotes (BRCA1 = 541). Cumulative annual breast cancer incidence was assessed at 2, 5, 10, and >10 years after ovarian cancer diagnosis date. RESULTS Breast cancer annual rates were evaluated in 701 assessable women with no breast cancer at ovarian diagnosis (BRCA1 = 425). Incidence was lower at 2 years (1.18%) and 2 to 5 years (1.13%) but rose thereafter for BRCA1 with incidence post 10 years in excess of 4% annually. Breast cancer pathology in BRCA1 PV heterozygotes showed less high-grade triple-negative breast cancer and more lower-grade hormone-receptor-positive cancer than women with no prior ovarian cancer. In the prospective cohort from ovarian cancer diagnosis, <4% of all deaths were caused by breast cancer, although 50% of deaths in women with breast cancer after ovarian cancer diagnosis were due to breast cancer. CONCLUSION Women can be reassured that incidence of breast cancer after ovarian cancer diagnosis is relatively low. It appears likely that this effect is due to platinum-based chemotherapy. Nonetheless women need to be aware that incidence increases thereafter, especially after 10 years.
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Affiliation(s)
- D Gareth Evans
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Prevent Breast Cancer Centre, Wythenshawe Hospital Manchester Universities Foundation Trust, Wythenshawe, Manchester, United Kingdom; Manchester Breast Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, United Kingdom.
| | - Robert D Morgan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Emma J Crosbie
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Sacha J Howell
- Prevent Breast Cancer Centre, Wythenshawe Hospital Manchester Universities Foundation Trust, Wythenshawe, Manchester, United Kingdom; Manchester Breast Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, United Kingdom; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Claire Forde
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Anthony Howell
- Prevent Breast Cancer Centre, Wythenshawe Hospital Manchester Universities Foundation Trust, Wythenshawe, Manchester, United Kingdom; Manchester Breast Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, United Kingdom; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Emma R Woodward
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Prevent Breast Cancer Centre, Wythenshawe Hospital Manchester Universities Foundation Trust, Wythenshawe, Manchester, United Kingdom; Manchester Breast Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, United Kingdom
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Yuan H, Xiu L, Li N, Li Y, Wu L, Yao H. PARPis response and outcome of ovarian cancer patients with BRCA1/2 germline mutation and a history of breast cancer. J Gynecol Oncol 2024; 35:e51. [PMID: 38246184 PMCID: PMC11262894 DOI: 10.3802/jgo.2024.35.e51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/24/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The aim of this study was to determine the poly (ADP-ribose) polymerase inhibitors (PARPis) response and outcome of ovarian cancer (OC) patients with BRCA1/2 germline mutation and a history of breast cancer (BC). METHODS Thirty-nine OC patients with BRCA1/2 germline mutation and a history of BC were included. The clinicopathological characteristics, PARPis response and prognosis were analyzed. RESULTS The median interval from BC to OC diagnosis was 115.3 months (range=6.4-310.1). A total of 38 patients (38/39, 97.4%) received platinum-based chemotherapy after surgical removal. The majority of these patients were reported to be platinum sensitive (92.1%, 35/38). 21 patients (53.8%) received PARPis treatment with 16 patients (76.2%) for maintenance treatment and 5 patients (5/21, 23.8%) for salvage treatment. The median duration for PARPis maintenance and salvage treatment was 14.9 months (range=2.0-56.9) and 8.2 months (range=5.2-20.7), respectively. In the entire cohort, 5-year progression-free survival (PFS) and overall survival (OS) rate was 33.1% and 78.9%, respectively. Patients with BRCA1 mutation had a non-significantly worse 5-year PFS (28.6% vs. 45.8%, p=0.346) and 5-year OS (76.9% vs. 83.3%, p=0.426) than those with BRCA2 mutation. In patients with stage III-IV (n=31), first line PARPis maintenance treatment associated with a non-significantly better PFS (median PFS: NR vs. 22.4 months; 5-year PFS: 64.3% vs. 21.9%, p=0.096). CONCLUSION The current study shows that these patients may have a good response to platinum-based chemotherapy and a favorable survival. And these patients can benefit from PARPis treatment and will likely be suitable candidates for PARPis.
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Affiliation(s)
- Hua Yuan
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Xiu
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Li
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yifan Li
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingying Wu
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongwen Yao
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Yuan H, Zhang R, Li N, Yao H. Primary fallopian tube cancer followed by primary breast cancer in RAD51C mutation carrier treated with niraparib as first line maintenance therapy: a case report. Hered Cancer Clin Pract 2024; 22:2. [PMID: 38360632 PMCID: PMC10868093 DOI: 10.1186/s13053-024-00274-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024] Open
Abstract
Given the rarity of RAD51C mutations, the risk and treatment of metachronous breast cancer after the diagnosis of ovarian cancer in RAD51C mutation carriers is not clear, especially for those who have received PARPi treatment. We report the case of a 65-year-old woman diagnosed with stage IIIC high-grade serous primary fallopian tube cancer. The patient had no family history of breast or ovarian cancer. The patient received three cycles of neoadjuvant chemotherapy with paclitaxel and carboplatin and achieved a complete response. After interval debulking surgery, the patient received three cycles of adjuvant chemotherapy. Collection and extraction of saliva DNA for next-generation sequencing identified a RAD51C mutation c.838-2 A > G. The patient received niraparib as front-line maintenance treatment. After 36 months of niraparib treatment, the patient had grade II invasive ductal carcinoma of the left breast that was positive for estrogen receptor (90%) and Ki-67 (30%) and negative for progesterone receptor and human epidermal growth factor receptor 2. Computed tomography revealed the absence of distant metastases. Modified radical mastectomy and axillary lymph node dissection were then performed. The final pathological report of the breast showed a 1.8 cm Bloom-Richardson grade II invasive ductal carcinoma in the left breast with axillary lymph node metastasis (1/21). Finally, the breast cancer was stage IIA, pT1cN1M0. The metachronous breast cancer in this case may be the first report of second primary cancer in fallopian tube cancer patient harboring a RAD51C mutation during niraparib treatment. Further studies are required to determine optimal treatment.
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Affiliation(s)
- Hua Yuan
- Department of Gynecologic Oncology, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Rong Zhang
- Department of Gynecologic Oncology, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Ning Li
- Department of Gynecologic Oncology, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Hongwen Yao
- Department of Gynecologic Oncology, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 # Panjiayuannanli, Chaoyang District, Beijing, 100021, P.R. China.
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4
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Wong SM, Apostolova C, Eisenberg E, Foulkes WD. Counselling Framework for Germline BRCA1/2 and PALB2 Carriers Considering Risk-Reducing Mastectomy. Curr Oncol 2024; 31:350-365. [PMID: 38248108 PMCID: PMC10814079 DOI: 10.3390/curroncol31010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Female BRCA1/2 and PALB2 germline pathogenic variant carriers have an increased lifetime risk of breast cancer and may wish to consider risk-reducing mastectomy (RRM) for surgical prevention. Quantifying the residual lifetime risk and absolute benefit from RRM requires careful consideration of a patient's age, pathogenic variant, and their personal history of breast or ovarian cancer. Historically, patients have been counselled that RRM does not necessarily prolong survival relative to high-risk surveillance, although recent studies suggest a possible survival benefit of RRM in BRCA1 carriers. The uptake of RRM has increased dramatically over the last several decades yet varies according to sociodemographic factors and geographic region. The increased adoption of nipple-sparing mastectomy techniques, ability to avoid axillary staging, and availability of reconstructive options for most germline pathogenic variant carriers has helped to minimize the morbidity of RRM. Preoperative discussions should include evidence regarding postmastectomy sensation, the potential for supplemental surgery, pregnancy-related chest wall changes, and the need for continued clinical surveillance. Approaches that include sensation preservation and robotic nipple-sparing mastectomy are an area of evolving research that may be more widely adopted in the future.
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Affiliation(s)
- Stephanie M. Wong
- Department of Surgery, McGill University, Montreal, QC H3G 1A4, Canada
- Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
| | - Carla Apostolova
- Department of Surgery, McGill University, Montreal, QC H3G 1A4, Canada
- Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Elisheva Eisenberg
- Department of Surgery, McGill University, Montreal, QC H3G 1A4, Canada
- Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - William D. Foulkes
- Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada
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5
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Lee EG, Lim J, Ha HI, Lim MC, Chang YJ, Won YJ, Jung SY. Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study. Front Oncol 2023; 13:1208320. [PMID: 37781206 PMCID: PMC10539581 DOI: 10.3389/fonc.2023.1208320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background Second primary cancer has become an important issue among cancer survivors. This study sought to determine the differences in clinicopathologic outcomes between second primary breast cancer (SPBC) after ovarian cancer and primary breast cancer (PBC) in the Republic of Korea. Methods and materials We searched the Korea Central Cancer Registry and identified 251,244 breast cancer cases that were diagnosed between 1999 and 2017. The incident rate and standardized incidence ratio (SIR) were calculated. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to age, histological type, and cancer stage. Results Among the 228,329 patients included, 228,148 were patients with PBC, and 181 patients had SPBC diagnosed after ovarian cancer (OC). The mean ages at diagnosis were 56.09 ± 10.81 years for SPBC and 50.65 ± 11.40 years for PBC. Patients with SPBC were significantly less likely than patients with PBC to receive adjuvant radiotherapy (14.92% vs. 21.92%, p = 0.02) or adjuvant chemotherapy (44.75% vs. 55.69%, p < 0.01). Based on the age-standardized rate (ASR), the incidence of SPBC after OC was 293.58 per 100,000 ovarian cancer patients and the incidence of PBC was 39.13 per 100,000 women. The SIR for SPBC was 1.27 (1.09-1.46, 95% Confidence interval) in the patients overall. The 5-year OS rates were 72.88% and 89.37% for SPBC and PBC (p < 0.01). The OS rate in SPBC decreased significantly with advanced stage and older age. Conclusion The incidence of breast cancer is about 1.27 times higher in ovarian cancer patients than in healthy people. The survival outcomes were worse for SPBC than for PBC and were related to older age and advanced stage. Active screening for breast cancer is necessary in ovarian cancer patients.
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Affiliation(s)
- Eun-Gyeong Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jiwon Lim
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Hyeong In Ha
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Myong Cheol Lim
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Tumor Immunology, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Young-Joo Won
- Division of Health Administration, Yonsei University, Wonju, Republic of Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
- Cancer Healthcare Research Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
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Oliveira D, Fernandes S, Miguel I, Fragoso S, Vaz F. Is There a Role for Risk-Reducing Bilateral Breast Surgery in BRCA1/2 Ovarian Cancer Survivors? An Observational Study. Curr Oncol 2023; 30:7810-7817. [PMID: 37754482 PMCID: PMC10528403 DOI: 10.3390/curroncol30090567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Risk-reducing surgeries are an option for cancer risk management in BRCA1/2 individuals. However, while adnexectomy is commonly recommended in breast cancer (BC) survivors, risk-reducing bilateral breast surgery (RRBBS) is controversial in ovarian cancer (OC) survivors due to relapse rates and mortality. METHODS We conducted a retrospective analysis of BRCA1/2-OC survivors, with OC as first cancer diagnosis. RESULTS Median age at OC diagnosis for the 69 BRCA1/2-OC survivors was 54 years. Median overall survival was 8 years, being significantly higher for BRCA2 patients than for BRCA1 patients (p = 0.011). Nine patients (13.2%) developed BC at a median age of 61 years. The mean overall BC-free survival was 15.5 years (median not reached). Eight patients (11.8%) underwent bilateral mastectomy (5 simultaneous with BC treatment; 3 RRBBS) at a median age of 56.5 years. The median time from OC to bilateral mastectomy/RRBBS was 5.5 years. CONCLUSIONS This study adds evidence regarding a lower BC risk after BRCA1/2-OC and higher survival for BRCA2-OC patients. A comprehensive analysis of the competing risks of OC mortality and recurrence against the risk of BC should be individually addressed. Surgical BC risk management may be considered for longer BRCA1/2-OC disease-free survivors. Ultimately, these decisions should always be tailored to patients' characteristics and preferences.
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Affiliation(s)
- Daniela Oliveira
- Medical Genetics Unit, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal;
- University Clinic of Genetics, Faculdade de Medicina, Universidade de Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal
| | - Sofia Fernandes
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
| | - Isália Miguel
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
- Medical Oncology Service, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
| | - Sofia Fragoso
- Molecular Pathobiology Research Unit, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal;
| | - Fátima Vaz
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
- Medical Oncology Service, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
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Gentle CK, Alkhatib H, Valente SA, Tu C, Pratt DA. Stage IV Non-breast Cancer Patients and Screening Mammography: It is Time to Stop. Ann Surg Oncol 2022; 29:6361-6366. [PMID: 35849289 DOI: 10.1245/s10434-022-12132-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/02/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patients diagnosed with metastatic cancer have shortened life expectancy with questionable benefit of routine screening mammography (SM). The aim of this study was to evaluate the incidence and consequences of continued SM in the setting of reduced survival from stage IV non-breast cancer. METHODS Women diagnosed with Stage IV non-breast cancer at a single institution from 2015 to 2019 were queried from the institutional tumor registry for demographics, stage IV cancer diagnosis, and survival. Incidence and timing of SM after stage IV diagnosis and further diagnostic workup were extracted from the medical record. RESULTS 790 women with Stage IV non-breast cancer were identified, 109 (14%) had at least 1 SM, 23% required diagnostic mammography, 7% breast biopsy, and 1% breast surgery. No breast cancers were identified. SM was ordered most often in stage IV gynecological cancers (28%), with more common cancers still seeing a high percentage of patients screened (lung 10%, colorectal 15%). Study 3-year survival was 26% (95% confidence interval [CI] 23-30%), with 74% mortality during follow up and median time from Stage IV diagnosis to death of 1.2 years (CI 0.4-2.3 years). Of patients screened, 41/109 died within 2 years of undergoing SM. CONCLUSIONS Despite low overall survival for patients diagnosed with metastatic non-breast cancer, 14% of women underwent SM which resulted in additional imaging, biopsies, and surgery with no new breast cancers identified. Continued SM in this population offers risk without benefit of reduced breast cancer mortality and should no longer continue in women with stage IV non-breast cancer.
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Affiliation(s)
- Corey K Gentle
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | | | - Stephanie A Valente
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Chao Tu
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Debra A Pratt
- Division of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
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8
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Management of Hereditary Breast Cancer: An Overview. Breast Cancer 2022. [DOI: 10.1007/978-981-16-4546-4_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Morrow M. Surgery and prophylactic surgery in hereditary breast cancer. Breast 2021; 62 Suppl 1:S63-S66. [PMID: 34924253 PMCID: PMC9097803 DOI: 10.1016/j.breast.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/12/2021] [Indexed: 10/29/2022] Open
Abstract
Women with hereditary breast cancer are at increased risk of second primary cancers in the ipsilateral and contralateral breast. The level of risk varies with mutation and age at first breast cancer diagnosis. These factors as well as life expectancy should be considered when selecting the surgical approach.
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Affiliation(s)
- Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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10
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John CS, Fong A, Alban R, Gillen J, Moore KM, Walsh CS, Li AJ, Rimel BJ, Amersi F, Cass I. Breast cancer surveillance following ovarian cancer in BRCA mutation carriers. Gynecol Oncol 2021; 164:202-207. [PMID: 34862065 DOI: 10.1016/j.ygyno.2021.10.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES BRCA 1 or 2 mutation carriers have increased risk of developing breast cancer (BC) and serous epithelial ovarian cancer (EOC). The incidence of BC over time after EOC is unknown. Optimal BC surveillance for BRCA mutation carriers following EOC has not been defined. METHODS A multi-institutional retrospective chart review was performed. Patients with BRCA -associated EOC diagnosed between 1996 and 2016 were followed for an average of 80 months. Women with previous bilateral mastectomy were excluded; women with prior BC and an intact breast were included. Descriptive statistics, Chi Square, and univariate survival analysis were performed. RESULTS 184 patients with BRCA -associated EOC were identified. Eighteen (10%) were diagnosed with BC a median of 48 months following EOC. Two (1%) with prior BC developed contralateral BC and 16 (9%) developed primary BC. The majority of BC (55%) was diagnosed 3 years following EOC. The 3-, 5- and 10-year incidence of BC was 5.6%, 9.5% and 33.3%. Annual mammography was performed in 43% and MRI in 34%. Twenty-eight (15%) women underwent risk-reducing mastectomy (RRM). There was no statistically significant difference in BC screening between women with, and without, a prior BC. BC was most commonly detected on mammogram. Three (17%) women had occult BC at the time of RRM. Nine (50%) had DCIS, and 8 (44%) had stage I/II BC. Median 5- and 10-year survival was 68% and 43% and was comparable between groups. CONCLUSIONS Ten percent of women developed BC after EOC. The incidence of BC following EOC in BRCA carriers increases over time, and surveillance is recommended given their enhanced survival of EOC. Timely genetic testing for women with EOC is imperative to better triage BC screening resources and treatment.
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Affiliation(s)
- Catherine S John
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Abigail Fong
- Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Rodrigo Alban
- Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jessica Gillen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK, USA
| | - Kathleen M Moore
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK, USA
| | - Christine S Walsh
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Andrew J Li
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - B J Rimel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Farin Amersi
- Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ilana Cass
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Safra T, Waissengrin B, Gerber D, Bernstein-Molho R, Klorin G, Salman L, Josephy D, Chen-Shtoyerman R, Bruchim I, Frey MK, Pothuri B, Muggia F. Breast cancer incidence in BRCA mutation carriers with ovarian cancer: A longitudal observational study. Gynecol Oncol 2021; 162:715-719. [PMID: 34172288 DOI: 10.1016/j.ygyno.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/10/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We evaluated the incidence of breast cancer and overall survival in a multi-center cohort of ovarian cancer patients carrying BRCA1/2 mutations in order to assess risks and formulate optimal preventive interventions and/or surveillance. METHODS Medical records of 502 BRCA1/2 mutation carriers diagnosed with ovarian cancer between 2000 and 2018 at 7 medical centers in Israel and one in New York were retrospectively analyzed for breast cancer diagnosis. Data included demographics, type of BRCA mutations, surveillance methods, timing of breast cancer diagnosis, and family history of cancer. RESULTS The median age at diagnosis of ovarian cancer was 55.8 years (range, 23.9-90.1). A third (31.5%) had a family history of breast cancer and 17.1% of ovarian cancer. Most patients (67.3%) were Ashkenazi Jews, 72.9% were BRCA1 carriers. Breast cancer preceded ovarian cancer in 17.5% and was diagnosed after ovarian cancer in 6.2%; an additional 2.2% had a synchronous presentation. Median time to breast cancer diagnosis after ovarian cancer was 46.0 months (range, 11-168). Of those diagnosed with both breast cancer and ovarian cancer (n = 31), 83.9% and 16.1% harbored BRCA1 and BRCA2 mutations, respectively. No deaths from breast cancer were recorded. Overall survival did not differ statistically between patients with an ovarian cancer diagnosis only and those diagnosed with breast cancer after ovarian cancer. CONCLUSION The low incidence of breast cancer after ovarian cancer in women carrying BRCA1/2 mutations suggests that routine breast surveillance, rather than risk-reducing surgical interventions, may be sufficient in ovarian cancer survivors.
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Affiliation(s)
- Tamar Safra
- New York University Cancer Institute, New York, ,NY, United States of America; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel.
| | | | - Deanna Gerber
- New York University Cancer Institute, New York, ,NY, United States of America
| | - Rinat Bernstein-Molho
- Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel; Chaim Sheba Medical Center, Breast Cancer Center, Oncology Institute, Ramat Gan, Israel
| | - Geula Klorin
- Rambam Health Care Campus, Haifa, Israel; Technion Institute of Technology, Rappaport School of Medicine, Haifa, Israel
| | | | - Dana Josephy
- Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel; Meir Medical Center, Kfar Saba, Israel
| | - Rakefet Chen-Shtoyerman
- The Oncogenetic Clinic, The Clinical Genetics Institute, Kaplan Medical Center, Rehovot, Israel; Ariel University, Ariel, Israel
| | - Ilan Bruchim
- Technion Institute of Technology, Rappaport School of Medicine, Haifa, Israel; Hillel Yaffe Medical Center, Hadera, Israel
| | - Melissa K Frey
- New York University Cancer Institute, New York, ,NY, United States of America
| | - Bhavana Pothuri
- New York University Cancer Institute, New York, ,NY, United States of America
| | - Franco Muggia
- New York University Cancer Institute, New York, ,NY, United States of America
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12
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Fong A, Cass I, John C, Gillen J, Moore KM, Gangi A, Walsh C, Li AJ, Rimel BJ, Karlan BY, Amersi F. Breast Cancer Surveillance Following Ovarian Cancer in BRCA Mutation Carriers. Am Surg 2020; 86:1243-1247. [DOI: 10.1177/0003134820964208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BRCA1 or 2 mutations result in higher cancer risk for breast cancer (BC) and epithelial ovarian cancer (EOC) for carriers than exists in the general population. Optimal breast imaging surveillance in these patients has not been well defined. An Institutional Review Board-approved, multi-institutional retrospective chart review was performed. Patients diagnosed with BRCA-associated EOC between 1990-2015 were identified; demographic and clinical data were collected and analyzed. 192 BRCA mutation–positive patients with EOC were identified. 16/192 (8.3%) women were diagnosed with BC following EOC, at a median of 50 (range 5-327) months following EOC diagnosis and median age 59.5 (45-84) years. Breast cancer was most commonly detected on mammogram 7/16 (44%) or clinical exam 7/16 (44%). 2/16 (12.5%) had occult BC found during risk-reducing mastectomy. 14 (88%) had early-stage (0-2) disease. At mean follow-up of 8.1 years, 6 (37.5%) patients with BC following EOC had died due to EOC. The risk of BC diagnosis following EOC in BRCA mutation carriers is low; most of these BCs are early stage and diagnosed with mammography or physical exam. Overall, survival in BRCA mutation carriers is dominated by EOC-related mortality. Breast cancer surveillance in BRCA mutation carriers following EOC should prioritize nonsurgical strategies.
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Affiliation(s)
- Abigail Fong
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ilana Cass
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | | | | | - Andrew J. Li
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Farin Amersi
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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13
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Chen C, Xu Y, Huang X, Mao F, Shen S, Xu Y, Sun Q. Clinical characteristics and survival outcomes of patients with both primary breast cancer and primary ovarian cancer. Medicine (Baltimore) 2020; 99:e21560. [PMID: 32769897 PMCID: PMC7593036 DOI: 10.1097/md.0000000000021560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Breast cancer and ovarian cancer are closely related. The major common risk factors of these 2 types of cancer are likely genetic factors. However, few studies have shown any common characteristics in patients who have both types of these 2 cancers. The purpose of this retrospective study is to explore the clinical characteristics and survival outcomes of patients with both primary breast cancer and primary ovarian cancer.A cohort of patients who had a history of both primary breast cancer and primary ovarian cancer were enrolled, and they received treatment in the Peking Union Medical College Hospital between January 1, 2010, and December 31, 2018. Both descriptive statistics analysis and survival analysis were performed for analysis.A total of 114 patients with both primary breast cancer and primary ovarian cancer were included in the study. The median (range) follow-up was 129.5 (20-492) months. The average interval time between the diagnosis of 2 types of cancer was 79.4 months in patients having ovarian cancer firstly and was 115.9 months in patients having breast cancer firstly. The 5- and 10-year overall survival (OS) rates were 91.5% and 81.7% for patients with ovarian cancer following breast cancer, respectively, and 90.6% and 87.5% for patients with breast cancer following ovarian cancer, respectively. Multivariate analysis revealed that independent predictors of OS were the age of diagnosis of the first tumor and the time interval between two types of tumor in patients with ovarian cancer following breast cancer.Most breast cancer or ovarian cancer occurred within 5 years after being diagnosed with the first tumor, and the interval time was significantly shorter in patients with previous ovarian cancer. The prognosis is likely positively correlated to the interval time between the occurrences of two types of cancer.
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14
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Matsuo K, Mandelbaum RS, Machida H, Yoshihara K, Matsuzaki S, Klar M, Muggia FM, Roman LD, Wright JD. Temporal trends of subsequent breast cancer among women with ovarian cancer: a population-based study. Arch Gynecol Obstet 2020; 301:1235-1245. [PMID: 32206877 DOI: 10.1007/s00404-020-05508-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/12/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE To examine trends, characteristics and outcomes of women who develop both ovarian and breast cancers. METHODS This is a retrospective study examining the Surveillance, Epidemiology, and End Results Program from 1973 to 2013. Among ovarian cancer (n = 133,149) and breast cancer (n = 1,143,219) cohorts, women with both diagnoses were identified and temporal trends, tumor characteristics and survival were examined. RESULTS There were 6446 women with both malignancies, representing 4.8% of the ovarian cancer cohort and 0.6% of the breast cancer cohort. Women with ovarian cancer who had secondary breast cancer were younger than those without secondary breast cancer early in the study period (52.3 versus 59.2 in 1973) but older in more recent years (68.5 versus 62.1 in 2013, P < 0.001). The number of breast cancer survivors who developed postcedent ovarian cancer decreased from 1.5 to 0.2% from 1979 to 2008 (relative risk reduction 90.0%, P < 0.05). Similarly, the number of ovarian cancer survivors who developed postcedent breast cancer decreased from 7.2 to 2.0% from 1973 to 2008 (relative risk reduction 72.4%, P < 0.05). Tumor characteristics were more likely to be favorable in women with ovarian cancer who developed postcedent breast cancer but unfavorable in those who had antecedent breast cancer (all, P < 0.05). Women with ovarian cancer who had secondary breast cancer had superior cause-specific survival compared to those who did not develop breast cancer regardless of breast cancer timing (P < 0.05). CONCLUSION Our study demonstrated that the demographics of women who develop breast cancer and ovarian cancer have changed over time and diagnosis of secondary breast cancer after ovarian cancer has decreased.
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Affiliation(s)
- Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD 520, Los Angeles, CA, 90033, USA. .,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
| | - Rachel S Mandelbaum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD 520, Los Angeles, CA, 90033, USA
| | - Hiroko Machida
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
| | - Shinya Matsuzaki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD 520, Los Angeles, CA, 90033, USA
| | - Maximilian Klar
- Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany
| | - Franco M Muggia
- Division of Medical Oncology, Department of Medicine, New York University, New York, NY, USA
| | - Lynda D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD 520, Los Angeles, CA, 90033, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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15
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Su L, Xu Y, Ouyang T, Li J, Wang T, Fan Z, Fan T, Lin B, Xie Y. Contralateral breast cancer risk in
BRCA1
and
BRCA2
mutation carriers in a large cohort of unselected Chinese breast cancer patients. Int J Cancer 2020; 146:3335-3342. [PMID: 32037537 DOI: 10.1002/ijc.32918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/22/2020] [Accepted: 02/04/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Liming Su
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Ye Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Tao Ouyang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Jinfeng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Tianfeng Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Zhaoqing Fan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Tie Fan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Benyao Lin
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
| | - Yuntao Xie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center Beijing Cancer Hospital & Institute, Peking University Cancer Hospital Beijing People's Republic of China
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16
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Le Page C, Rahimi K, Rodrigues M, Heinzelmann-Schwarz V, Recio N, Tommasi S, Bataillon G, Portelance L, Golmard L, Meunier L, Tonin PN, Gotlieb W, Yasmeen A, Ray-Coquard I, Labidi-Galy SI, Provencher D, Mes-Masson AM. Clinicopathological features of women with epithelial ovarian cancer and double heterozygosity for BRCA1 and BRCA2: A systematic review and case report analysis. Gynecol Oncol 2019; 156:377-386. [PMID: 31753525 DOI: 10.1016/j.ygyno.2019.11.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Carriers of pathogenic variants in both BRCA1 and BRCA2 genes as a double mutation (BRCA1/2 DM) have been rarely reported in women with epithelial ovarian cancer (EOC). METHODS We reviewed the English literature and interrogated three repositories reporting EOC patients carrying BRCA1/2 DM. The clinicopathological parameters of 36 EOC patients carrying germline BRCA1/2 DM were compared to high-grade serous EOC women of the COEUR cohort with known germline BRCA1/BRCA2 mutation carrier status (n = 376 non-carriers, n = 65 BRCA1 and n = 38 BRCA2). Clinicopathological parameters evaluated were age at diagnosis, stage of disease, loss of heterozygosity, type of mutation, immunohistochemistry profile, progression occurrence and survival. RESULTS Median age at diagnosis of BRCA1/2 DM patients was 51.9 years, similar to BRCA1 mutation carriers (49.7 years, p = .58) and younger than BRCA2 mutation carriers (58.1 years, p = .02). Most patients were diagnosed at advanced stage (III-IV; 82%) and were carriers of founder/frequent mutations (69%). Tissue immunostainings revealed no progesterone receptor expression and low intraepithelial inflammation. The 5-year survival rate (60%) was significantly lower than that of BRCA2 mutation carriers (76%, p = .03) but not of BRCA1 mutation carriers (51%, p = .37). CONCLUSIONS Our data suggests some co-dominant effect of both mutations but the outcome of these patients more closely resembled that of BRCA1 mutation carriers with poor prognosis factors.
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Affiliation(s)
- Cécile Le Page
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada.
| | - Kurosh Rahimi
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada; Department of Pathology, Centre hospitalier de l'Université de Montreal (CHUM), Montreal, QC, Canada
| | - Manuel Rodrigues
- Institut Curie, PSL Research University, Paris, France; Department of Medical Oncology, INSERM U830 "Cancer, heterogeneity, instability and plasticity", Paris, France
| | - Viola Heinzelmann-Schwarz
- Gynecological Cancer Centre and Ovarian Cancer Research Group, University Hospital Basel and Department of Biomedicine, Basel, Switzerland
| | - Neil Recio
- Departments of Human Genetics, McGill University; Cancer Research Program, The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | | | - Guillaume Bataillon
- Institut Curie, PSL Research University, Paris, France; Department of Biopathology, Paris, France
| | - Lise Portelance
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada
| | - Lisa Golmard
- Institut Curie, PSL Research University, Paris, France; Department of Genetics, Paris, France
| | - Liliane Meunier
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada
| | - Patricia N Tonin
- Departments of Human Genetics, McGill University; Cancer Research Program, The Research Institute of the McGill University Health Centre, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada
| | - Walter Gotlieb
- Segal Cancer Center, Lady Davis Institute of Medical research, McGill University, Montreal, QC, Canada
| | - Amber Yasmeen
- Segal Cancer Center, Lady Davis Institute of Medical research, McGill University, Montreal, QC, Canada
| | | | - S Intidhar Labidi-Galy
- Department of Oncology, Hôpitaux Universitaires de Genève and Department of Medicine, Faculty of Medicine, Geneva, Switzerland
| | - Diane Provencher
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada; Division of Gynecology-Oncology, CHUM, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC, Canada
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université de Montreal (CRCHUM), and Institut du cancer de Montréal, Montreal, QC, Canada; Department of Medicine, University of Montreal, Montreal, QC, Canada.
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17
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Zhang W, Zhang W, Lin Z, Wang F, Li M, Zhu L, Yu Y, Gao Y. Survival Outcomes of Patients with Primary Breast Cancer Following Primary Ovarian Cancer. Med Sci Monit 2019; 25:3869-3879. [PMID: 31125329 PMCID: PMC6545065 DOI: 10.12659/msm.914163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Patients with primary breast cancer following primary ovarian cancer do not comprise a large clinical entity, and reports of the survival outcomes of this cohort are rare. The purpose of this retrospective population-based research was to investigate the survival outcomes of patients with primary breast cancer after primary ovarian cancer. Material/Methods A cohort of patients diagnosed with primary breast cancer following primary ovarian cancer between 1973 and 2014 was drawn from the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) database. Cox proportional hazards survival regression analysis and Kaplan-Meier were applied to calculate overall survival (OS), cancer-specific survival (CSS), and independent predictors of CSS. Results A total of 1455 patients with primary breast cancer following primary ovarian cancer were identified. The 5-year and 10-year OS rates for the entire cohort were 81.7% and 67.4%, respectively. The 5-year and 10-year CSS rates were 84.2% and 74.3% for ovarian cancer, and 76.0% and 67.8% for breast cancer, respectively. Multivariate analysis revealed that independent predictors of ovarian cancer CSS include age, cancer stage, diagnosis time, and histological subtype. Conclusions Patients diagnosed with breast cancer following ovarian cancer have better survival rates. Patients age, ovarian cancer stage, ovarian cancer histological type, and time of diagnose affect the survival rate.
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Affiliation(s)
- Wei Zhang
- Department of Gynaecology, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China (mainland)
| | - Wenque Zhang
- Department of Gynaecology, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China (mainland)
| | - Zhihong Lin
- Department of Gynaecology, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China (mainland)
| | - Fang Wang
- Department of Gynaecology, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China (mainland)
| | - Miaojie Li
- Department of Gynaecology, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China (mainland)
| | - Libo Zhu
- Department of Gastroenterology, Dali Bai Autonomous Prefecture People's Hospital, Dali, Yunnan, China (mainland)
| | - Yixian Yu
- Department of Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Yutao Gao
- Department of Gynecology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
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18
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Muti M, Muti M. Electrochemical Determination of Label Free BRCA Hybridization by Single Use Antioxidant Modified Electrode. ELECTROANAL 2017. [DOI: 10.1002/elan.201700256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Merve Muti
- Adnan Menderes University; Faculty of Arts and Sciences, Department of Chemistry; 09010 Aydın Turkey
- Adnan Menderes University; Söke Vocational School, Mechatronics Program; 09200 Aydın Turkey
| | - Mihrican Muti
- Adnan Menderes University; Faculty of Arts and Sciences, Department of Chemistry; 09010 Aydın Turkey
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19
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When to Consider Risk-Reducing Mastectomy in BRCA1/BRCA2 Mutation Carriers with Advanced Stage Ovarian Cancer: a Case Study Illustrating the Genetic Counseling Challenges. J Genet Couns 2017; 26:1173-1178. [PMID: 28780755 PMCID: PMC5672852 DOI: 10.1007/s10897-017-0136-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/18/2017] [Indexed: 11/06/2022]
Abstract
Germline mutations in BRCA1/BRCA2 significantly increase the risk of breast and ovarian cancer in women. This case report describes a BRCA1 germline mutation identified in a woman with stage IV epithelial ovarian cancer and the provision of genetic counseling about BRCA1-associated breast cancer risk in the three years following diagnosis. The report centers on the patient’s enquiry about risk-reducing breast surgery. We focus on the challenges for health professionals and patients in understanding and balancing the risks and benefits of major prophylactic surgery in the context of a potentially life-limiting cancer diagnosis. Breast cancer risk management in BRCA1/BRCA2 carriers with advanced ovarian cancer is an under-explored area of genetic counseling research. This article includes a case report, a review of the relevant literature and considers some implications for practice.
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20
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Gamble C, Havrilesky LJ, Myers ER, Chino JP, Hollenbeck S, Plichta JK, Kelly Marcom P, Shelley Hwang E, Kauff ND, Greenup RA. Cost Effectiveness of Risk-Reducing Mastectomy versus Surveillance in BRCA Mutation Carriers with a History of Ovarian Cancer. Ann Surg Oncol 2017; 24:3116-3123. [PMID: 28699130 DOI: 10.1245/s10434-017-5995-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The appropriate management of breast cancer risk in BRCA mutation carriers following ovarian cancer diagnosis remains unclear. We sought to determine the survival benefit and cost effectiveness of risk-reducing mastectomy (RRM) among women with BRCA1/2 mutations following stage II-IV ovarian cancer. DESIGN We constructed a decision model from a third-party payer perspective to compare annual screening with magnetic resonance imaging (MRI) and mammography to annual screening followed by RRM with reconstruction following ovarian cancer diagnosis. Survival, overall costs, and cost effectiveness were determined by decade at diagnosis using 2015 US dollars. All inputs were obtained from the literature and public databases. Monte Carlo probabilistic sensitivity analysis was performed with a $100,000 willingness-to-pay threshold. RESULTS The incremental cost-effectiveness ratio (ICER) per year of life saved (YLS) for RRM increased with age and BRCA2 mutation status, with greater survival benefit demonstrated in younger patients with BRCA1 mutations. RRM delayed 5 years in 40-year-old BRCA1 mutation carriers was associated with 5 months of life gained (ICER $72,739/YLS), and in 60-year-old BRCA2 mutation carriers was associated with 0.8 months of life gained (ICER $334,906/YLS). In all scenarios, $/YLS and mastectomies per breast cancer prevented were lowest with RRM performed 5-10 years after ovarian cancer diagnosis. CONCLUSION For most BRCA1/2 mutation carriers following ovarian cancer diagnosis, RRM performed within 5 years is not cost effective when compared with breast cancer screening. Imaging surveillance should be advocated during the first several years after ovarian cancer diagnosis, after which point the benefits of RRM can be considered based on patient age and BRCA mutation status.
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Affiliation(s)
- Charlotte Gamble
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Laura J Havrilesky
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.,Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Evan R Myers
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Junzo P Chino
- Duke Cancer Institute, Durham, NC, USA.,Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Scott Hollenbeck
- Department of General Surgery, Division of Plastics, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC, USA
| | - Jennifer K Plichta
- Duke Cancer Institute, Durham, NC, USA.,Department of Surgery, Division of Advanced Oncologic and Gastrointestinal Surgery, Duke University Medical Center, Durham, NC, USA
| | - P Kelly Marcom
- Duke Cancer Institute, Durham, NC, USA.,Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA
| | - E Shelley Hwang
- Duke Cancer Institute, Durham, NC, USA.,Department of Surgery, Division of Advanced Oncologic and Gastrointestinal Surgery, Duke University Medical Center, Durham, NC, USA
| | - Noah D Kauff
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Rachel A Greenup
- Duke Cancer Institute, Durham, NC, USA. .,Department of Surgery, Division of Advanced Oncologic and Gastrointestinal Surgery, Duke University Medical Center, Durham, NC, USA.
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21
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Managing hereditary breast cancer risk in women with and without ovarian cancer. Gynecol Oncol 2017; 146:205-214. [PMID: 28454658 DOI: 10.1016/j.ygyno.2017.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/16/2017] [Accepted: 04/19/2017] [Indexed: 12/12/2022]
Abstract
Current guidelines recommend that all women with ovarian cancer undergo germline genetic testing for BRCA1/2. Increasingly, genetic testing is being performed via panels that include other genes that confer a high or moderate risk of breast cancer. In addition, many women with a family history of breast or ovarian cancer are not found to have a mutation, but may have increased risk of breast cancer for which surveillance and risk reduction strategies are indicated. This review discusses how to assess and manage an increased risk of breast cancer through surveillance, preventive medications, and risk-reducing surgery. Assessing and managing the increased risk of breast cancer in BRCA1/2 mutation carriers after a diagnosis of ovarian cancer can be challenging. For the first few years after an ovarian cancer diagnosis, BRCA1/2 mutation carriers have a relatively low risk of breast cancer, and their prognosis is largely determined by the ovarian cancer. However, if these women remain in remission after two years, the risk of breast cancer becomes comparable with, and in some cases exceeds, their risk of ovarian cancer recurrence. For these women, breast cancer surveillance and risk reduction becomes important to their overall health. Specifically, for BRCA1/2 carriers who are diagnosed with early-stage ovarian cancer, we recommend regular breast cancer surveillance and consideration of risk reduction with medication and/or prophylactic mastectomy. For women with advanced ovarian cancer who do not achieve remission, breast cancer surveillance or prophylaxis is not of value. However, among carriers with more favorable advanced disease, it is reasonable to initiate breast cancer surveillance. Patients with less favorable advanced stage disease who achieve sustained remission (>2-5years) should also consider more aggressive strategies for breast cancer screening and prevention. For mutation carriers who remain in remission after five years, prophylactic mastectomy can be considered.
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22
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Risk of breast cancer after a diagnosis of ovarian cancer in BRCA mutation carriers: Is preventive mastectomy warranted? Gynecol Oncol 2017; 145:346-351. [PMID: 28314588 DOI: 10.1016/j.ygyno.2017.02.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/15/2017] [Accepted: 02/19/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Preventive breast surgery and MRI screening are offered to unaffected BRCA mutation carriers. The clinical benefit of these two modalities has not been evaluated among mutation carriers with a history of ovarian cancer. Thus, we sought to determine whether or not BRCA mutation carriers with ovarian cancer would benefit from preventive mastectomy or from MRI screening. METHODS First, the annual mortality rate for ovarian cancer patients was estimated for a cohort of 178 BRCA mutation carriers from Ontario, Canada. Next, the actuarial risk of developing breast cancer was estimated using an international registry of 509 BRCA mutation carriers with ovarian cancer. A series of simulations was conducted to evaluate the reduction in the probability of death (from all causes) associated with mastectomy and with MRI-based breast surveillance. Cox proportional hazards models were used to evaluate the impacts of mastectomy and MRI screening on breast cancer incidence as well as on all-cause mortality. RESULTS Twenty (3.9%) of the 509 patients developed breast cancer within ten years following ovarian cancer diagnosis. The actuarial risk of developing breast cancer at ten years post-diagnosis, conditional on survival from ovarian cancer and other causes of mortality was 7.8%. Based on our simulation results, among all BRCA mutation-carrying patients diagnosed with stage III/IV ovarian cancer at age 50, the chance of dying before age 80 was reduced by less than 1% with MRI and by less than 2% with mastectomy. Greater improvements in survival with MRI or mastectomy were observed for women who had already survived 10years after ovarian cancer, and for women with stage I or II ovarian cancer. CONCLUSIONS Among BRCA mutation-carrying ovarian cancer patients without a personal history of breast cancer, neither preventive mastectomy nor MRI screening is warranted, except for those who have survived ovarian cancer without recurrence for ten years and for those with early stage ovarian cancer.
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Daniels MS, Lu KH. Genetic predisposition in gynecologic cancers. Semin Oncol 2016; 43:543-547. [DOI: 10.1053/j.seminoncol.2016.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/10/2016] [Indexed: 11/11/2022]
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van den Broek AJ, van 't Veer LJ, Hooning MJ, Cornelissen S, Broeks A, Rutgers EJ, Smit VTHBM, Cornelisse CJ, van Beek M, Janssen-Heijnen ML, Seynaeve C, Westenend PJ, Jobsen JJ, Siesling S, Tollenaar RAEM, van Leeuwen FE, Schmidt MK. Impact of Age at Primary Breast Cancer on Contralateral Breast Cancer Risk in BRCA1/2 Mutation Carriers. J Clin Oncol 2015; 34:409-18. [PMID: 26700119 DOI: 10.1200/jco.2015.62.3942] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To determine prospectively overall and age-specific estimates of contralateral breast cancer (CBC) risk for young patients with breast cancer with or without BRCA1/2 mutations. PATIENTS AND METHODS A cohort of 6,294 patients with invasive breast cancer diagnosed under 50 years of age and treated between 1970 and 2003 in 10 Dutch centers was tested for the most prevalent BRCA1/2 mutations. We report absolute risks and hazard ratios within the cohort from competing risk analyses. RESULTS After a median follow-up of 12.5 years, 578 CBCs were observed in our study population. CBC risk for BRCA1 and BRCA2 mutation carriers was two to three times higher than for noncarriers (hazard ratios, 3.31 [95% CI, 2.41 to 4.55; P < .001] and 2.17 [95% CI,1.22 to 3.85; P = .01], respectively). Ten-year cumulative CBC risks were 21.1% (95% CI, 15.4 to 27.4) for BRCA1, 10.8% (95% CI, 4.7 to 19.6) for BRCA2 mutation carriers and 5.1% (95% CI, 4.5 to 5.7) for noncarriers. Age at diagnosis of the first breast cancer was a significant predictor of CBC risk in BRCA1/2 mutation carriers only; those diagnosed before age 41 years had a 10-year cumulative CBC risk of 23.9% (BRCA1: 25.5%; BRCA2: 17.2%) compared with 12.6% (BRCA1: 15.6%; BRCA2: 7.2%) for those 41 to 49 years of age (P = .02); our review of published studies showed ranges of 24% to 31% before age 40 years (BRCA1: 24% to 32%; BRCA2:17% to 29%) and 8% to 21% after 40 years (BRCA1: 11% to 52%; BRCA2: 7% to 18%), respectively. CONCLUSION Age at first breast cancer is a strong risk factor for cumulative CBC risk in BRCA1/2 mutation carriers. Considering the available evidence, age-specific risk estimates should be included in counseling.
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Affiliation(s)
- Alexandra J van den Broek
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Laura J van 't Veer
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Maartje J Hooning
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Sten Cornelissen
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Annegien Broeks
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Emiel J Rutgers
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Vincent T H B M Smit
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Cees J Cornelisse
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Mike van Beek
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Maryska L Janssen-Heijnen
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Caroline Seynaeve
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Pieter J Westenend
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Jan J Jobsen
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Sabine Siesling
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Rob A E M Tollenaar
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Flora E van Leeuwen
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
| | - Marjanka K Schmidt
- Alexandra J. van den Broek, Laura J. van 't Veer, Sten Cornelissen, Annegien Broeks, Emiel J. Rutgers, Flora E. van Leeuwen, and Marjanka K. Schmidt, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Maartje J. Hooning and Caroline Seynaeve, Erasmus MC Cancer Institute, Rotterdam; Vincent T.H.B.M. Smit, Cees J. Cornelisse, and Rob A.E.M. Tollenaar, Leiden University Medical Center, Leiden; Mike van Beek, PAMM, Catharina Hospital, Eindhoven; Maryska L. Janssen-Heijnen, Netherlands Comprehensive Cancer Organization, Eindhoven, and VieCuri Medical Centre, Venlo; Pieter J. Westenend, Laboratory for Pathology, Dordrecht; Jan J. Jobsen, Medisch Spectrum Twente, Enschede; and Sabine Sieling, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands.
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Li J, Zheng S, Chen B, Butte AJ, Swamidass SJ, Lu Z. A survey of current trends in computational drug repositioning. Brief Bioinform 2015; 17:2-12. [PMID: 25832646 DOI: 10.1093/bib/bbv020] [Citation(s) in RCA: 338] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Indexed: 12/26/2022] Open
Abstract
Computational drug repositioning or repurposing is a promising and efficient tool for discovering new uses from existing drugs and holds the great potential for precision medicine in the age of big data. The explosive growth of large-scale genomic and phenotypic data, as well as data of small molecular compounds with granted regulatory approval, is enabling new developments for computational repositioning. To achieve the shortest path toward new drug indications, advanced data processing and analysis strategies are critical for making sense of these heterogeneous molecular measurements. In this review, we show recent advancements in the critical areas of computational drug repositioning from multiple aspects. First, we summarize available data sources and the corresponding computational repositioning strategies. Second, we characterize the commonly used computational techniques. Third, we discuss validation strategies for repositioning studies, including both computational and experimental methods. Finally, we highlight potential opportunities and use-cases, including a few target areas such as cancers. We conclude with a brief discussion of the remaining challenges in computational drug repositioning.
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Molina-Montes E, Pérez-Nevot B, Pollán M, Sánchez-Cantalejo E, Espín J, Sánchez MJ. Cumulative risk of second primary contralateral breast cancer in BRCA1/BRCA2 mutation carriers with a first breast cancer: A systematic review and meta-analysis. Breast 2014; 23:721-42. [PMID: 25467311 DOI: 10.1016/j.breast.2014.10.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/05/2014] [Accepted: 10/12/2014] [Indexed: 12/19/2022] Open
Abstract
BRCA1/2 mutation carriers are at a higher risk of breast cancer and of subsequent contralateral breast cancer (CBC). This study aims to evaluate the evidence of the effect of the BRCA1/2-carriership on CBC cumulative risk in female breast cancer patients. The literature was searched in Pubmed and Embase up to June 2013 for studies on CBC risk after a first primary invasive breast cancer in female BRCA1/2 mutation carriers. A qualitative synthesis was carried out and the methodological quality of the studies evaluated. Cumulative risks of CBC after 5, 10 and 15 years since the first breast cancer diagnosis were pooled by BRCA1/2 mutation status. A total number of 20 articles, out of 1324 retrieved through the search, met the inclusion criteria: 18 retrospective and 2 prospective cohort studies. Cumulative risks of up to five studies were pooled. The cumulative 5-years risk of CBC for BRCA1 and BRCA2 mutation carriers was 15% (95% CI: 9.5%-20%) and 9% (95% CI: 5%-14%), respectively. This risk increases with time since diagnosis of the first breast cancer; the 10-years risk increased up to 27% and 19%, respectively. The 5-years cumulative risk was remarkably lower in non-BRCA carriers (3%; 95% CI: 2%-5%) and remained so over subsequent years (5%; 95% CI: 3%-7%). In conclusion, risk of CBC increases with length of time after the first breast cancer diagnosis in BRCA1/2 mutation carriers. Studies addressing the impact of treatment-related factors and clinical characteristics of the first breast cancer on this risk are warranted.
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Affiliation(s)
- Esther Molina-Montes
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain
| | - Beatriz Pérez-Nevot
- Clinical Analysis Service, Virgen de la Victoria University Hospital, Malaga, Spain
| | - Marina Pollán
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Emilio Sánchez-Cantalejo
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain
| | - Jaime Espín
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain
| | - María-José Sánchez
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain.
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Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the breast cancer family registry. Breast 2014; 23:482-8. [PMID: 24821458 DOI: 10.1016/j.breast.2014.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/03/2014] [Accepted: 04/04/2014] [Indexed: 11/21/2022] Open
Abstract
While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30-0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40-1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34-1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59-2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63-1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50-3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk.
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Oosterwijk JC, de Vries J, Mourits MJ, de Bock GH. Genetic testing and familial implications in breast-ovarian cancer families. Maturitas 2014; 78:252-7. [PMID: 24894332 DOI: 10.1016/j.maturitas.2014.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/01/2014] [Indexed: 12/19/2022]
Abstract
DNA-testing for BRCA1 and BRCA2 has become incorporated in the diagnostic procedure of patients with breast and/or ovarian cancer. Since 1994 an immense amount of information has been gathered on mutation spectra, mutation risk assessment, cancer risks for mutation carriers, factors that modify these risks, unclassified DNA variants, surveillance strategies and preventive options. For the patient and family the main determinator still is whether a mutation is found or not. When a pathogenic mutation is detected in an index case, relatives can opt for pre-symptomatic DNA testing. However in the vast majority no mutation, or only unclear mutations are detectable yet. This means that a hereditary cause cannot be excluded, but pre-symptomatic DNA-testing is still unavailable for relatives. Surveillance for both index cases and relatives is based of the family history of cancer. Next generation genetic testing may help to elucidate genetic causes in these families.
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Affiliation(s)
- Jan C Oosterwijk
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | - Jakob de Vries
- Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Marian J Mourits
- Department of Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Walker MJ, Mirea L, Cooper K, Nabavi M, Glendon G, Andrulis IL, Knight JA, O'Malley FP, Chiarelli AM. Impact of familial risk and mammography screening on prognostic indicators of breast disease among women from the Ontario site of the Breast Cancer Family Registry. Fam Cancer 2013; 13:163-72. [PMID: 24097051 DOI: 10.1007/s10689-013-9689-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Although several studies have found screen-detected cancers in women with familial breast cancer risk have favorable prognostic features compared with symptomatic cancers, the impact of level of familial risk is unknown. A cohort of 899 first-degree female relatives of cases of breast cancer from the Ontario site of the Breast Cancer Family Registry was followed for 2 years. Logistic regression analyses compared diagnoses of breast cancer or benign breast disease (BBD) between women at high (n = 258, 28.7 %) versus low/moderate (n = 641, 71.3 %) familial risk. Similar analyses compared prognostic features of invasive cancers and BBD by level of familial risk and mammography screening status. Among 899 women, 44 (4.9 %) were diagnosed with invasive breast cancer and/or ductal carcinoma in situ, and 56 (6.2 %) with BBD. Women with high familial risk were significantly more likely to be diagnosed with breast cancer [odds ratio (OR) = 2.84, 95 % confidence interval (CI) 1.50-5.38] than low/moderate risk women, particularly if diagnosed at age ≥50 (OR = 2.99, 95 % CI 1.37-6.56) or screened with mammography (OR = 3.33, 95 % CI 1.54-7.18). High risk women were more likely to be diagnosed with BBD (OR = 1.94, 95 % CI 1.03-3.66). Level of familial risk was not associated with prognostic features. Cancers among unscreened women were larger (OR = 9.72, 95 % CI 1.01-93.61) and diagnosed at stage II or above (OR = 7.80, 95 % CI 1.18-51.50) compared with screen-detected cancers. Screening mammography may be effective for women with a first-degree family history of breast cancer, irrespective of level of familial risk.
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Affiliation(s)
- Meghan J Walker
- Division of Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, ON, M5G 2L7, Canada,
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