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Garcia AI, Buisson M, Damiola F, Tessereau C, Barjhoux L, Verny-Pierre C, Sornin V, Dondon MG, Eon-Marchais S, Caron O, Gautier-Villars M, Coupier I, Buecher B, Vennin P, Belotti M, Lortholary A, Gesta P, Dugast C, Noguès C, Fricker JP, Faivre L, Stoppa-Lyonnet D, Andrieu N, Sinilnikova OM, Mazoyer S. Mutation screening of MIR146A/B and BRCA1/2 3'-UTRs in the GENESIS study. Eur J Hum Genet 2016; 24:1324-9. [PMID: 26785832 DOI: 10.1038/ejhg.2015.284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 01/08/2023] Open
Abstract
Although a wide number of breast cancer susceptibility alleles associated with various levels of risk have been identified to date, about 50% of the heritability is still missing. Although the major BRCA1 and BRCA2 genes are being extensively screened for truncating and missense variants in breast and/or ovarian cancer families, potential regulatory variants affecting their expression remain largely unexplored. In an attempt to identify such variants, we focused our attention on gene regulation mediated by microRNAs (miRs). We screened two genes, MIR146A and MIR146B, producing miR-146a and miR-146b-5p, respectively, that regulate BRCA1, and the 3'- untranslated regions (3'-UTRs) of BRCA1 and BRCA2 in the GENESIS French national case/control study (BRCA1- and BRCA2-negative breast cancer cases with at least one sister with breast cancer and matched controls). We identified one rare variant in MIR146A, four in MIR146B, five in BRCA1 3'-UTR and one in BRCA2 3'-UTR in 716 index cases and 619 controls. Among these 11 rare variants, 7 were identified each in 1 index case. None of the three relevant MIR146A/MIR146B variants affected the pre-miR sequences. The potential causality of the four relevant BRCA1/BRCA2 3'-UTRs variants was evaluated with luciferase reporter assays and co-segregation studies, as well as with bioinformatics analyses to predict miRs-binding sites, RNA secondary structures and RNA accessibility. This is the first study to report the screening of miR genes and of BRCA2 3'-UTR in a large series of familial breast cancer cases. None of the variant identified in this study gave convincing evidence of potential pathogenicity.
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Affiliation(s)
- Amandine I Garcia
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Monique Buisson
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Francesca Damiola
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Chloé Tessereau
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Laure Barjhoux
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Carole Verny-Pierre
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Valérie Sornin
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
| | - Marie-Gabrielle Dondon
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France
| | - Séverine Eon-Marchais
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France
| | | | - Olivier Caron
- Département de Médecine Oncologique, Institut de Cancérologie Gustave Roussy, Villejuif, France
| | | | - Isabelle Coupier
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique médicale et Oncogénétique, Montpellier, France.,ICM Val d'Aurel, Unité d'Oncogénétique, Montpellier, France
| | | | | | | | - Alain Lortholary
- Centre Catherine de Sienne, Service d'Oncologie Médicale, Nantes, France
| | - Paul Gesta
- CH Georges Renon, Service Oncogénétique pour la consultation oncogénétique régionale Poitou-Charentes, Niort, France
| | | | | | | | - Laurence Faivre
- Hôpital d'Enfants, Service de Génétique Médicale, Dijon, France.,Centre Georges François Leclerc, Oncogénétique, Dijon, France
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Service de Génétique, Paris, France.,Inserm, U830, Université Paris-Descartes, Paris, France
| | - Nadine Andrieu
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France
| | - Olga M Sinilnikova
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France.,Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon/Centre Léon Bérard, Lyon, France
| | - Sylvie Mazoyer
- Cancer Research Centre of Lyon, CNRS UMR5286/Inserm U1052/Université Lyon 1, Centre Léon Bérard, Lyon, France
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Blein S, Barjhoux L, Damiola F, Dondon MG, Eon-Marchais S, Marcou M, Caron O, Lortholary A, Buecher B, Vennin P, Berthet P, Noguès C, Lasset C, Gauthier-Villars M, Mazoyer S, Stoppa-Lyonnet D, Andrieu N, Thomas G, Sinilnikova OM, Cox DG. Targeted Sequencing of the Mitochondrial Genome of Women at High Risk of Breast Cancer without Detectable Mutations in BRCA1/2. PLoS One 2015; 10:e0136192. [PMID: 26406445 PMCID: PMC4583250 DOI: 10.1371/journal.pone.0136192] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/31/2015] [Indexed: 12/30/2022] Open
Abstract
Breast Cancer is a complex multifactorial disease for which high-penetrance mutations have been identified. Approaches used to date have identified genomic features explaining about 50% of breast cancer heritability. A number of low- to medium penetrance alleles (per-allele odds ratio < 1.5 and 4.0, respectively) have been identified, suggesting that the remaining heritability is likely to be explained by the cumulative effect of such alleles and/or by rare high-penetrance alleles. Relatively few studies have specifically explored the mitochondrial genome for variants potentially implicated in breast cancer risk. For these reasons, we propose an exploration of the variability of the mitochondrial genome in individuals diagnosed with breast cancer, having a positive breast cancer family history but testing negative for BRCA1/2 pathogenic mutations. We sequenced the mitochondrial genome of 436 index breast cancer cases from the GENESIS study. As expected, no pathogenic genomic pattern common to the 436 women included in our study was observed. The mitochondrial genes MT-ATP6 and MT-CYB were observed to carry the highest number of variants in the study. The proteins encoded by these genes are involved in the structure of the mitochondrial respiration chain, and variants in these genes may impact reactive oxygen species production contributing to carcinogenesis. More functional and epidemiological studies are needed to further investigate to what extent variants identified may influence familial breast cancer risk.
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Affiliation(s)
- Sophie Blein
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Laure Barjhoux
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | | | - Francesca Damiola
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Marie-Gabrielle Dondon
- Inserm, U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - Séverine Eon-Marchais
- Inserm, U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | | | - Olivier Caron
- Consultation de Génétique, Département de Médecine, Institut de Cancérologie Gustave Roussy, Villejuif, France
| | | | - Bruno Buecher
- Institut Curie, Department of Tumour Biology, Paris, France
| | - Philippe Vennin
- Département de Cancérologie sénologique, CLCC Oscar Lambret, Lille, France
| | | | - Catherine Noguès
- Oncogénétique Clinique, Hôpital René Huguenin/Institut Curie, Saint-Cloud, France
| | - Christine Lasset
- Université Lyon 1, CNRS UMR5558, Lyon, France
- Unité de Prévention et d’Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Marion Gauthier-Villars
- Consultation de Génétique, Département de Médecine, Institut de Cancérologie Gustave Roussy, Villejuif, France
| | - Sylvie Mazoyer
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Dominique Stoppa-Lyonnet
- Consultation de Génétique, Département de Médecine, Institut de Cancérologie Gustave Roussy, Villejuif, France
- Institut Curie, INSERM U830, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, France
| | - Nadine Andrieu
- Inserm, U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - Gilles Thomas
- Université Lyon 1, INCa-Synergie, Centre Léon Bérard, 28 rue Laennec, Lyon Cedex 08, France
| | - Olga M. Sinilnikova
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon - Centre Léon Bérard, Lyon, France
| | - David G. Cox
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Turpin A, Mailliez A, Vennin P, Bonneterre J. [What do clinicians do with the results of the systematic staging imaging at the time of the breast cancer diagnosis?]. ACTA ACUST UNITED AC 2014; 42:325-30. [PMID: 24411340 DOI: 10.1016/j.gyobfe.2013.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Asymptomatic distant metastasis is often looked for at the time of initial diagnosis of early breast cancer. However, there is no consensus on when to perform it and on the consequences on the treatment. PATIENTS AND METHODS One hundred and twenty-three asymptomatic women receiving systemic neoadjuvant (32 patients) or adjuvant treatment (91 patients) for breast cancer at the Oscar-Lambret center in September 2011 were considered. The staging imaging was a PET scan for 59 patients (pts), a CT scan and a bone scan for 59 patients and both for 5 patients. The result for each procedure was considered normal, abnormal but typically benign or potentially malignant. In this case, another imaging technique was carried out to confirm the suspected diagnosis. The patient was considered metastatic if the results of two different procedures were concordant and eventually in case of response to chemotherapy. RESULTS Nine pts were considered metastatic (9/125=7%). They were stage 1: 1, stage 2: 4 and stage 3: 4. The staging by CT, abdomen and pelvis scan coupled with bone scintigraphy discriminated five metastatic patients with overdiagnosis of 33 benign lesions and the need of 20 additional confirmatory tests. Similarly, the PET staging, more expensive, only discriminated two metastatic patients and 15 benign lesions requiring 20 confirmatory tests. CONCLUSION These results support the international recommendations to make a staging from stage IIIA. The CT, abdominal and pelvic scan coupled with bone scintigraphy should be considered as a gold standard in breast cancer staging.
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Affiliation(s)
- A Turpin
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - A Mailliez
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France.
| | - P Vennin
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - J Bonneterre
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France; Université de Lille Nord de France, 59000 Lille, France
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Le Rhun E, Taillibert S, Zairi F, Kotecki N, Devos P, Mailliez A, Servent V, Vanlemmens L, Vennin P, Boulanger T, Baranzelli MC, André C, Marliot G, Cazin JL, Dubois F, Assaker R, Bonneterre J, Chamberlain MC. A retrospective case series of 103 consecutive patients with leptomeningeal metastasis and breast cancer. J Neurooncol 2013; 113:83-92. [PMID: 23456656 DOI: 10.1007/s11060-013-1092-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 02/17/2013] [Indexed: 01/17/2023]
Abstract
Approximately 2-5 % of patients with breast cancer (BC) develop leptomeningeal metastasis (LM). 103 consecutive patients with BC were diagnosed with LM and initially treated with intra-CSF liposomal cytarabine from 2007 to 2011 at a single institution. Correlations were determined with respect to patient characteristics and BC subtype with regard to overall survival (OS). At LM diagnosis, 61 % of patients had a 0-2 performance status (PS), the remaining 39 % were severely neurologically impaired. Regardless of PS, all patients received intra-cerebrospinal fluid (CSF) liposomal cytarabine as first-line treatment. Systemic treatment and radiotherapy were also given in 58 and 17 % of patients respectively as clinically appropriate. Second- (intra-CSF thiotepa) and third-line (intra-CSF methotrexate) treatment was administered in 24 and 6 patients respectively. Median OS was 3.8 months (range 1 day-2.8 years). In multivariate analysis, an initial combined treatment, a second-line treatment with intra-CSF thiotepa, an initial clinical response, and a non-'ER/PR/HER2 negative' BC were significantly associated with a better OS. Median OS in this heterogeneous retrospective case series was similar to that of previously observed BC patients treated with intra-CSF methotrexate suggesting intra-CSF liposomal cytarabine is a reasonable first choice therapy of BC-related LM.
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Affiliation(s)
- E Le Rhun
- Department of Medical Oncology, Oscar Lambret Center, 3 rue Frédéric Combemale, 59020 Lille Cedex, France.
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Pujol P, Lasset C, Berthet P, Dugast C, Delaloge S, Fricker JP, Tennevet I, Chabbert-Buffet N, This P, Baudry K, Lemonnier J, Roca L, Mijonnet S, Gesta P, Chiesa J, Dreyfus H, Vennin P, Delnatte C, Bignon YJ, Lortholary A, Prieur F, Gladieff L, Lesur A, Clough KB, Nogues C, Martin AL. Uptake of a randomized breast cancer prevention trial comparing letrozole to placebo in BRCA1/2 mutations carriers: the LIBER trial. Fam Cancer 2012; 11:77-84. [PMID: 22076253 DOI: 10.1007/s10689-011-9484-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Women with germline BRCA1 or BRCA2 (BRCA1/2) mutations are considered as an extreme risk population for developing breast cancer. Prophylactic mastectomy provides a valid option to reduce such risk, impacting however, the quality of life. Medical prevention by aromatase inhibitor that has also recently shown to have preventive effect may thus be considered as an alternative. LIBER is an ongoing double-blind, randomized phase III trial to evaluate the efficacy of 5-year letrozole versus placebo to decrease breast cancer incidence in post-menopausal BRCA1/2 mutation carriers (NCT00673335). We present data on the uptake of this trial. We compared characteristics of women in the LIBER trial (n = 113) to those of women enrolled in the prospective ongoing national GENEPSO cohort (n = 1,505). Uptake was evaluated through a survey sent to all active centres, with responses obtained from 17 to the 20 (85%) centres. According to the characteristics of the women enrolled in the GENEPSO cohort and the survey, approximately one-third of BRCA1/2 mutation carriers were eligible for the trial. Five hundred and thirty-four women eligible from chart review have been informed by mail about the prevention trial and were invited to an oral information by participating centres. Forty-four percentage of them came to the dedicated medical visit. Uptake of drug prevention trial was 32% among women informed orally and 15% of all the eligible women. The main reasons of refusal were: potential side effects, probability to receive the placebo and lack of support from their physicians. Additionally, we noticed that prior prophylactic oophorectomy and previous unilateral breast cancer were more frequent in women enrolled in the LIBER trial than in the French cohort (93% vs. 60% and 50% vs. 39%, respectively). Based on an overall 15% uptake among all eligible subjects, greater and wider information of the trial should be offered to women with BRCA1/2 mutation to improve recruitment. Women with previous unilateral breast cancer or prior prophylactic oophorectomy are more likely to enter a medical prevention trial.
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Affiliation(s)
- Pascal Pujol
- Genetics and Cancer, University Hospital CHU Arnaud de Villeneuve, 371, Av G. Giraud, 34295, Montpellier Cedex 5, France.
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Jakubowska A, Rozkrut D, Antoniou A, Hamann U, Scott RJ, McGuffog L, Healy S, Sinilnikova OM, Rennert G, Lejbkowicz F, Flugelman A, Andrulis IL, Glendon G, Ozcelik H, Thomassen M, Paligo M, Aretini P, Kantala J, Aroer B, von Wachenfeldt A, Liljegren A, Loman N, Herbst K, Kristoffersson U, Rosenquist R, Karlsson P, Stenmark-Askmalm M, Melin B, Nathanson KL, Domchek SM, Byrski T, Huzarski T, Gronwald J, Menkiszak J, Cybulski C, Serrano P, Osorio A, Cajal TR, Tsitlaidou M, Benítez J, Gilbert M, Rookus M, Aalfs CM, Kluijt I, Boessenkool-Pape JL, Meijers-Heijboer HEJ, Oosterwijk JC, van Asperen CJ, Blok MJ, Nelen MR, van den Ouweland AMW, Seynaeve C, van der Luijt RB, Devilee P, Easton DF, Peock S, Frost D, Platte R, Ellis SD, Fineberg E, Evans DG, Lalloo F, Eeles R, Jacobs C, Adlard J, Davidson R, Eccles D, Cole T, Cook J, Godwin A, Bove B, Stoppa-Lyonnet D, Caux-Moncoutier V, Belotti M, Tirapo C, Mazoyer S, Barjhoux L, Boutry-Kryza N, Pujol P, Coupier I, Peyrat JP, Vennin P, Muller D, Fricker JP, Venat-Bouvet L, Johannsson OT, Isaacs C, Schmutzler R, Wappenschmidt B, Meindl A, Arnold N, Varon-Mateeva R, Niederacher D, Sutter C, Deissler H, Preisler-Adams S, Simard J, Soucy P, Durocher F, Chenevix-Trench G, Beesley J, Chen X, Rebbeck T, Couch F, Wang X, Lindor N, Fredericksen Z, Pankratz VS, Peterlongo P, Bonanni B, Fortuzzi S, Peissel B, Szabo C, Mai PL, Loud JT, Lubinski J. Association of PHB 1630 C>T and MTHFR 677 C>T polymorphisms with breast and ovarian cancer risk in BRCA1/2 mutation carriers: results from a multicenter study. Br J Cancer 2012; 106:2016-24. [PMID: 22669161 PMCID: PMC3388557 DOI: 10.1038/bjc.2012.160] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 03/18/2012] [Accepted: 03/25/2012] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The variable penetrance of breast cancer in BRCA1/2 mutation carriers suggests that other genetic or environmental factors modify breast cancer risk. Two genes of special interest are prohibitin (PHB) and methylene-tetrahydrofolate reductase (MTHFR), both of which are important either directly or indirectly in maintaining genomic integrity. METHODS To evaluate the potential role of genetic variants within PHB and MTHFR in breast and ovarian cancer risk, 4102 BRCA1 and 2093 BRCA2 mutation carriers, and 6211 BRCA1 and 2902 BRCA2 carriers from the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA) were genotyped for the PHB 1630 C>T (rs6917) polymorphism and the MTHFR 677 C>T (rs1801133) polymorphism, respectively. RESULTS There was no evidence of association between the PHB 1630 C>T and MTHFR 677 C>T polymorphisms with either disease for BRCA1 or BRCA2 mutation carriers when breast and ovarian cancer associations were evaluated separately. Analysis that evaluated associations for breast and ovarian cancer simultaneously showed some evidence that BRCA1 mutation carriers who had the rare homozygote genotype (TT) of the PHB 1630 C>T polymorphism were at increased risk of both breast and ovarian cancer (HR 1.50, 95%CI 1.10-2.04 and HR 2.16, 95%CI 1.24-3.76, respectively). However, there was no evidence of association under a multiplicative model for the effect of each minor allele. CONCLUSION The PHB 1630TT genotype may modify breast and ovarian cancer risks in BRCA1 mutation carriers. This association need to be evaluated in larger series of BRCA1 mutation carriers.
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Affiliation(s)
- A Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
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Frenay M, Met Domestici MA, Berthet P, Burel-Vandenbos F, Vennin P, Sobol H, Lebrun C, Mari V. Association of gliomas and BRCA 1 germline mutation: A possible linkage. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e12502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12502 Background: Gliomas are known to occur in association with several well-defined hereditary tumor syndromes such as NF1 and NF2, tuberous sclerosis, Li Fraumeni syndrom and Turcot syndrome. In addition, familial clustering of glioma in absence of these tumor syndrome have also been described. Methods: We have already reported the case of a 35 years old man who was diagnosed with an oligodendroglioma. Familial history reported 3 ovarian cancers at the first degree. Genetic testing had shown the BRCA1 exonic deletion c.3819del GTAAA, p. 1241 ter. (Patient 1 ) We collected 2 more cases of patients diagnosed with glioma and carrying BRCA1 mutation, whom have been seen by other physicians in an other hospital. Results: The second patient is a 59-year-old woman diagnosed with a glioblastoma with important oligodendroglioma differenciation (Patient 2). She was 43 at the time of diagnosis. At the age of 54, she developed a bilateral breast cancer. Moreover, the pedigree revealed a familial history of 4 breast cancers at the first degree. Genetic testing had shown the BRCA1 exonic substitution c.181T>G, p.Cys61Gly. The third patient is a 40-year -old woman diagnosed with an intra medullar pilocytic astrocytoma (Patient 3). This tumour is not usual which allows to keep in mind the genetic procedure. Beforehand, she had been diagnosed with a breast cancer at the age of 36. The pedigree revealed 6 breast cancers among the family and thus, BRCA analysis had been performed and showed the BRCA 1 exonic substitution c.3403 C>T, p.Gln 1135 X. Consequently, the patient had a prophylactic ovarian surgery at the age of 37 and contralateral prophylactic mastectomy at the age of 40. Interestingly, P1 had a BRCA1 deletion whereas P2 and P3 had BRCA1 substitution. On the other hand, P1 and P3 had Exon 11 mutation that both resulted in a truncated protein. Whereas, P2 had an exon 5 missens mutation. Conclusions: No specific association has been reported between BRCA1 mutation and glial tumor occurrence. These cases point out a possible relationship between BRCA1 germline mutation and glioma occurrence such as the relevance of familial history screening in glioma patients. Further investigations are needed to identify a disease-causing locus by genetic linkage analysis.
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Maxwell CA, Benítez J, Gómez-Baldó L, Osorio A, Bonifaci N, Fernández-Ramires R, Costes SV, Guinó E, Chen H, Evans GJR, Mohan P, Català I, Petit A, Aguilar H, Villanueva A, Aytes A, Serra-Musach J, Rennert G, Lejbkowicz F, Peterlongo P, Manoukian S, Peissel B, Ripamonti CB, Bonanni B, Viel A, Allavena A, Bernard L, Radice P, Friedman E, Kaufman B, Laitman Y, Dubrovsky M, Milgrom R, Jakubowska A, Cybulski C, Gorski B, Jaworska K, Durda K, Sukiennicki G, Lubiński J, Shugart YY, Domchek SM, Letrero R, Weber BL, Hogervorst FBL, Rookus MA, Collee JM, Devilee P, Ligtenberg MJ, van der Luijt RB, Aalfs CM, Waisfisz Q, Wijnen J, van Roozendaal CEP, Easton DF, Peock S, Cook M, Oliver C, Frost D, Harrington P, Evans DG, Lalloo F, Eeles R, Izatt L, Chu C, Eccles D, Douglas F, Brewer C, Nevanlinna H, Heikkinen T, Couch FJ, Lindor NM, Wang X, Godwin AK, Caligo MA, Lombardi G, Loman N, Karlsson P, Ehrencrona H, von Wachenfeldt A, Bjork Barkardottir R, Hamann U, Rashid MU, Lasa A, Caldés T, Andrés R, Schmitt M, Assmann V, Stevens K, Offit K, Curado J, Tilgner H, Guigó R, Aiza G, Brunet J, Castellsagué J, Martrat G, Urruticoechea A, Blanco I, Tihomirova L, Goldgar DE, Buys S, John EM, Miron A, Southey M, Daly MB, Schmutzler RK, Wappenschmidt B, Meindl A, Arnold N, Deissler H, Varon-Mateeva R, Sutter C, Niederacher D, Imyamitov E, Sinilnikova OM, Stoppa-Lyonne D, Mazoyer S, Verny-Pierre C, Castera L, de Pauw A, Bignon YJ, Uhrhammer N, Peyrat JP, Vennin P, Fert Ferrer S, Collonge-Rame MA, Mortemousque I, Spurdle AB, Beesley J, Chen X, Healey S, Barcellos-Hoff MH, Vidal M, Gruber SB, Lázaro C, Capellá G, McGuffog L, Nathanson KL, Antoniou AC, Chenevix-Trench G, Fleisch MC, Moreno V, Pujana MA. Interplay between BRCA1 and RHAMM regulates epithelial apicobasal polarization and may influence risk of breast cancer. PLoS Biol 2011; 9:e1001199. [PMID: 22110403 PMCID: PMC3217025 DOI: 10.1371/journal.pbio.1001199] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 10/10/2011] [Indexed: 12/24/2022] Open
Abstract
Differentiated mammary epithelium shows apicobasal polarity, and loss of tissue organization is an early hallmark of breast carcinogenesis. In BRCA1 mutation carriers, accumulation of stem and progenitor cells in normal breast tissue and increased risk of developing tumors of basal-like type suggest that BRCA1 regulates stem/progenitor cell proliferation and differentiation. However, the function of BRCA1 in this process and its link to carcinogenesis remain unknown. Here we depict a molecular mechanism involving BRCA1 and RHAMM that regulates apicobasal polarity and, when perturbed, may increase risk of breast cancer. Starting from complementary genetic analyses across families and populations, we identified common genetic variation at the low-penetrance susceptibility HMMR locus (encoding for RHAMM) that modifies breast cancer risk among BRCA1, but probably not BRCA2, mutation carriers: n = 7,584, weighted hazard ratio ((w)HR) = 1.09 (95% CI 1.02-1.16), p(trend) = 0.017; and n = 3,965, (w)HR = 1.04 (95% CI 0.94-1.16), p(trend) = 0.43; respectively. Subsequently, studies of MCF10A apicobasal polarization revealed a central role for BRCA1 and RHAMM, together with AURKA and TPX2, in essential reorganization of microtubules. Mechanistically, reorganization is facilitated by BRCA1 and impaired by AURKA, which is regulated by negative feedback involving RHAMM and TPX2. Taken together, our data provide fundamental insight into apicobasal polarization through BRCA1 function, which may explain the expanded cell subsets and characteristic tumor type accompanying BRCA1 mutation, while also linking this process to sporadic breast cancer through perturbation of HMMR/RHAMM.
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Affiliation(s)
- Christopher A. Maxwell
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Javier Benítez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain
- Biomedical Research Centre Network for Rare Diseases, Spain
| | - Laia Gómez-Baldó
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health, Spain
| | - Ana Osorio
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain
- Biomedical Research Centre Network for Rare Diseases, Spain
| | - Núria Bonifaci
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health, Spain
- Biomarkers and Susceptibility Unit, Catalan Institute of Oncology, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Ricardo Fernández-Ramires
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain
- Biomedical Research Centre Network for Rare Diseases, Spain
| | - Sylvain V. Costes
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States of America
| | - Elisabet Guinó
- Biomedical Research Centre Network for Epidemiology and Public Health, Spain
- Biomarkers and Susceptibility Unit, Catalan Institute of Oncology, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Helen Chen
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Gareth J. R. Evans
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Pooja Mohan
- Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Isabel Català
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Anna Petit
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Helena Aguilar
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Alberto Villanueva
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Alvaro Aytes
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Jordi Serra-Musach
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
- Biomarkers and Susceptibility Unit, Catalan Institute of Oncology, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Gad Rennert
- CHS National Cancer Control Center, Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Flavio Lejbkowicz
- CHS National Cancer Control Center, Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Paolo Peterlongo
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, and IFOM Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Carla B. Ripamonti
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, and IFOM Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia, Milan, Italy
| | - Alessandra Viel
- Division of Experimental Oncology 1, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Anna Allavena
- Department of Genetics, Biology and Biochemistry, University of Turin, Turin, Italy
| | - Loris Bernard
- Department of Experimental Oncology, Istituto Europeo di Oncologia, and Consortium for Genomics Technology (Cogentech), Milan, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, and IFOM Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Bella Kaufman
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Yael Laitman
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Maya Dubrovsky
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Roni Milgrom
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Anna Jakubowska
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Cezary Cybulski
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Bohdan Gorski
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Jaworska
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Durda
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Grzegorz Sukiennicki
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubiński
- International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Yin Yao Shugart
- Unit of Statistical Genetics, Division of Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland, United States of America
| | - Susan M. Domchek
- Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Richard Letrero
- Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Barbara L. Weber
- Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Frans B. L. Hogervorst
- Family Cancer Clinic, Department of Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Matti A. Rookus
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - J. Margriet Collee
- Department of Clinical Genetics, Rotterdam Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter Devilee
- Department of Genetic Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Rob B. van der Luijt
- Department of Clinical Molecular Genetics, Utrecht University Medical Center, Utrecht, the Netherlands
| | - Cora M. Aalfs
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands
| | - Quinten Waisfisz
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, the Netherlands
| | - Juul Wijnen
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - HEBON
- Hereditary Breast and Ovarian Cancer Group, the Netherlands
| | - EMBRACE
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Susan Peock
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Margaret Cook
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Clare Oliver
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - D. Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Fiona Lalloo
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Rosalind Eeles
- The Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, United Kingdom
| | - Louise Izatt
- Clinical Genetics, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Carol Chu
- Yorkshire Regional Genetics Service, St. James's Hospital, Leeds, United Kingdom
| | - Diana Eccles
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Fiona Douglas
- Institute of Human Genetics, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, United Kingdom
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Tuomas Heikkinen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Noralane M. Lindor
- Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Maria A. Caligo
- Section of Genetic Oncology, Department of Oncology, University of Pisa, and Department of Laboratory Medicine, University Hospital of Pisa, Pisa, Italy
| | - Grazia Lombardi
- Section of Genetic Oncology, Department of Oncology, University of Pisa, and Department of Laboratory Medicine, University Hospital of Pisa, Pisa, Italy
| | - Niklas Loman
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Per Karlsson
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hans Ehrencrona
- Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | | | - SWE-BRCA
- Swedish Breast Cancer Study, Sweden
| | | | - Ute Hamann
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Muhammad U. Rashid
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany, and Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Adriana Lasa
- Genetic Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Trinidad Caldés
- Molecular Oncology Laboratory, Hospital Clínico San Carlos, Madrid, Spain
| | - Raquel Andrés
- Medical Oncology Division, Hospital Clínico de Zaragoza, Zaragoza, Spain
| | - Michael Schmitt
- Department of Internal Medicine III, University of Rostock, Rostock, Germany
| | - Volker Assmann
- Center for Experimental Medicine, Institute of Tumor Biology, University Hospital Hamburg–Eppendorf, Hamburg, Germany
| | - Kristen Stevens
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Kenneth Offit
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - João Curado
- Bioinformatics and Genomics Group, Centre for Genomic Regulation (CRG), Biomedical Research Park of Barcelona (PRBB), Barcelona, Catalonia, Spain
| | - Hagen Tilgner
- Bioinformatics and Genomics Group, Centre for Genomic Regulation (CRG), Biomedical Research Park of Barcelona (PRBB), Barcelona, Catalonia, Spain
| | - Roderic Guigó
- Bioinformatics and Genomics Group, Centre for Genomic Regulation (CRG), Biomedical Research Park of Barcelona (PRBB), Barcelona, Catalonia, Spain
| | - Gemma Aiza
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Joan Brunet
- Genetic Counseling and Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL and Girona Biomedical Research Institute (IdIBGi), Catalonia, Spain
| | - Joan Castellsagué
- Genetic Counseling and Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL and Girona Biomedical Research Institute (IdIBGi), Catalonia, Spain
| | - Griselda Martrat
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Ander Urruticoechea
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
| | - Ignacio Blanco
- Genetic Counseling and Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL and Girona Biomedical Research Institute (IdIBGi), Catalonia, Spain
| | | | - David E. Goldgar
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Saundra Buys
- Department of Internal Medicine, Huntsman Cancer Institute, Salt Lake City, Utah, United States of America
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, California, United States of America
| | - Alexander Miron
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Department of Surgery, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Melissa Southey
- Centre for Molecular, Environmental, Genetic and Analytic (MEGA) Epidemiology, Melbourne School of Population Health, The University of Melbourne, Victoria, Australia
| | - Mary B. Daly
- Division of Population Science, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - BCFR
- Breast Cancer Family Registry, United States of America
| | - Rita K. Schmutzler
- Center for Familial Breast and Ovarian Cancer and Center of Integrated Oncology, University of Cologne, Cologne, Germany
| | - Barbara Wappenschmidt
- Center for Familial Breast and Ovarian Cancer and Center of Integrated Oncology, University of Cologne, Cologne, Germany
| | - Alfons Meindl
- Department of Obstetrics and Gynaecology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Norbert Arnold
- Division of Oncology, Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Helmut Deissler
- Department of Obstetrics and Gynecology, Ulm University, Ulm, Germany
| | | | - Christian Sutter
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Dieter Niederacher
- Division of Molecular Genetics, Department of Gynaecology and Obstetrics, Clinical Center University of Düsseldorf, Düsseldorf, Germany
| | - Evgeny Imyamitov
- N. N. Petrov Institute of Oncology, Saint-Petersburg, Russian Federation
| | - Olga M. Sinilnikova
- Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Centre Hospitalier Universitaire de Lyon, Centre Léon Bérard, Lyon, France
- Equipe labellisée LIGUE 2008, UMR5201 CNRS, Centre Léon Bérard, Université de Lyon, Lyon, France
| | - Dominique Stoppa-Lyonne
- INSERM U509, Service de Génétique Oncologique, Institut Curie, Université Paris-Descartes, Paris, France
| | - Sylvie Mazoyer
- Equipe labellisée LIGUE 2008, UMR5201 CNRS, Centre Léon Bérard, Université de Lyon, Lyon, France
| | - Carole Verny-Pierre
- Equipe labellisée LIGUE 2008, UMR5201 CNRS, Centre Léon Bérard, Université de Lyon, Lyon, France
| | - Laurent Castera
- INSERM U509, Service de Génétique Oncologique, Institut Curie, Université Paris-Descartes, Paris, France
| | - Antoine de Pauw
- INSERM U509, Service de Génétique Oncologique, Institut Curie, Université Paris-Descartes, Paris, France
| | - Yves-Jean Bignon
- Département d'Oncogénétique, Centre Jean Perrin, Université de Clermont-Ferrand, Clermont-Ferrand, France
| | - Nancy Uhrhammer
- Département d'Oncogénétique, Centre Jean Perrin, Université de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Philippe Peyrat
- Laboratoire d'Oncologie Moléculaire Humaine, Centre Oscar Lambret, Lille, France
| | - Philippe Vennin
- Consultation d'Oncogénétique, Centre Oscar Lambret, Lille, France
| | - Sandra Fert Ferrer
- Laboratoire de Génétique Chromosomique, Hôtel Dieu Centre Hospitalier, Chambéry, France
| | - Marie-Agnès Collonge-Rame
- Service de Génétique-Histologie-Biologie du Développement et de la Reproduction, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | | | - GEMO Study Collaborators
- GEMO Study (Genetics Network “Groupe Génétique et Cancer”), Fédération Nationale des Centres de Lutte Contre le Cancer, France
| | | | | | - Xiaoqing Chen
- Queensland Institute of Medical Research, Brisbane, Australia
| | - Sue Healey
- Queensland Institute of Medical Research, Brisbane, Australia
| | - kConFab
- The Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, Peter MacCallum Cancer Institute, East Melbourne, Australia
| | - Mary Helen Barcellos-Hoff
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States of America
| | - Marc Vidal
- Center for Cancer Systems Biology (CCSB) and Department of Cancer Biology, Dana-Farber Cancer Institute, and Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Stephen B. Gruber
- Department of Internal Medicine, Epidemiology, Human Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Conxi Lázaro
- Genetic Counseling and Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL and Girona Biomedical Research Institute (IdIBGi), Catalonia, Spain
| | - Gabriel Capellá
- Genetic Counseling and Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL and Girona Biomedical Research Institute (IdIBGi), Catalonia, Spain
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Katherine L. Nathanson
- Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - Markus C. Fleisch
- Department of Obstetrics and Gynaecologie, Heinrich-Heine-University, Duesseldorf, Germany
| | - Víctor Moreno
- Biomedical Research Centre Network for Epidemiology and Public Health, Spain
- Biomarkers and Susceptibility Unit, Catalan Institute of Oncology, IDIBELL, L'Hospitalet, Catalonia, Spain
| | - Miguel Angel Pujana
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Catalonia, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health, Spain
- Biomarkers and Susceptibility Unit, Catalan Institute of Oncology, IDIBELL, L'Hospitalet, Catalonia, Spain
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Taïeb S, Vennin P. Dépistage du cancer de l’ovaire : le point en 2011. Imagerie de la Femme 2011. [DOI: 10.1016/j.femme.2011.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Martrat G, Maxwell CM, Tominaga E, Porta-de-la-Riva M, Bonifaci N, Gómez-Baldó L, Bogliolo M, Lázaro C, Blanco I, Brunet J, Aguilar H, Fernández-Rodríguez J, Seal S, Renwick A, Rahman N, Kühl J, Neveling K, Schindler D, Ramírez MJ, Castellà M, Hernández G, Easton DF, Peock S, Cook M, Oliver CT, Frost D, Platte R, Evans DG, Lalloo F, Eeles R, Izatt L, Chu C, Davidson R, Ong KR, Cook J, Douglas F, Hodgson S, Brewer C, Morrison PJ, Porteous M, Peterlongo P, Manoukian S, Peissel B, Zaffaroni D, Roversi G, Barile M, Viel A, Pasini B, Ottini L, Putignano AL, Savarese A, Bernard L, Radice P, Healey S, Spurdle A, Chen X, Beesley J, Rookus MA, Verhoef S, Tilanus-Linthorst MA, Vreeswijk MP, Asperen CJ, Bodmer D, Ausems MGEM, van Os TA, Blok MJ, Meijers-Heijboer HEJ, Hogervorst FBL, Goldgar DE, Buys S, John EM, Miron A, Southey M, Daly MB, Harbst K, Borg A, Rantala J, Barbany-Bustinza G, Ehrencrona H, Stenmark-Askmalm M, Kaufman B, Laitman Y, Milgrom R, Friedman E, Domchek SM, Nathanson KL, Rebbeck TR, Johannsson OT, Couch FJ, Wang X, Fredericksen Z, Cuadras D, Moreno V, Pientka FK, Depping R, Caldés T, Osorio A, Benítez J, Bueren J, Heikkinen T, Nevanlinna H, Hamann U, Torres D, Caligo MA, Godwin AK, Imyanitov EN, Janavicius R, Sinilnikova OM, Stoppa-Lyonnet D, Mazoyer S, Verny-Pierre C, Castera L, de Pauw A, Bignon YJ, Uhrhammer N, Peyrat JP, Vennin P, Ferrer SF, Collonge-Rame MA, Mortemousque I, McGuffog L, Chenevix-Trench G, Pereira-Smith OM, Antoniou AC, Cerón J, Tominaga K, Surrallés J, Pujana MA. Exploring the link between MORF4L1 and risk of breast cancer. Breast Cancer Res 2011; 13:R40. [PMID: 21466675 PMCID: PMC3219203 DOI: 10.1186/bcr2862] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Revised: 02/17/2011] [Accepted: 04/05/2011] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Proteins encoded by Fanconi anemia (FA) and/or breast cancer (BrCa) susceptibility genes cooperate in a common DNA damage repair signaling pathway. To gain deeper insight into this pathway and its influence on cancer risk, we searched for novel components through protein physical interaction screens. METHODS Protein physical interactions were screened using the yeast two-hybrid system. Co-affinity purifications and endogenous co-immunoprecipitation assays were performed to corroborate interactions. Biochemical and functional assays in human, mouse and Caenorhabditis elegans models were carried out to characterize pathway components. Thirteen FANCD2-monoubiquitinylation-positive FA cell lines excluded for genetic defects in the downstream pathway components and 300 familial BrCa patients negative for BRCA1/2 mutations were analyzed for genetic mutations. Common genetic variants were genotyped in 9,573 BRCA1/2 mutation carriers for associations with BrCa risk. RESULTS A previously identified co-purifying protein with PALB2 was identified, MRG15 (MORF4L1 gene). Results in human, mouse and C. elegans models delineate molecular and functional relationships with BRCA2, PALB2, RAD51 and RPA1 that suggest a role for MRG15 in the repair of DNA double-strand breaks. Mrg15-deficient murine embryonic fibroblasts showed moderate sensitivity to γ-irradiation relative to controls and reduced formation of Rad51 nuclear foci. Examination of mutants of MRG15 and BRCA2 C. elegans orthologs revealed phenocopy by accumulation of RPA-1 (human RPA1) nuclear foci and aberrant chromosomal compactions in meiotic cells. However, no alterations or mutations were identified for MRG15/MORF4L1 in unclassified FA patients and BrCa familial cases. Finally, no significant associations between common MORF4L1 variants and BrCa risk for BRCA1 or BRCA2 mutation carriers were identified: rs7164529, Ptrend = 0.45 and 0.05, P2df = 0.51 and 0.14, respectively; and rs10519219, Ptrend = 0.92 and 0.72, P2df = 0.76 and 0.07, respectively. CONCLUSIONS While the present study expands on the role of MRG15 in the control of genomic stability, weak associations cannot be ruled out for potential low-penetrance variants at MORF4L1 and BrCa risk among BRCA2 mutation carriers.
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Affiliation(s)
- Griselda Martrat
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), Gran Via 199, L'Hospitalet del Llobregat 08908, Spain
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Kolesnikov-Gauthier H, Vanlemmens L, Baranzelli M, Carpentier P, Habbas S, Vennin P, Servent V, Fournier C, Bonneterre J. Predictive value of neoadjuvant chemotherapy failure in breast cancer using FDG-PET after the first course. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mailliez A, Vennin P. Chimiothérapie néoadjuvante dans les cancers du sein : objectifs, protocoles, évaluation, impacts. Imagerie de la Femme 2010. [DOI: 10.1016/j.femme.2010.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Christophe V, Vennin P, Corbeil M, Adenis C, Reich M. Social sharing of genetic information in the family: a study on hereditary breast and ovarian cancers. J Health Psychol 2010; 14:855-60. [PMID: 19786511 DOI: 10.1177/1359105309340981] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study assessed how preventive medical information about hereditary breast and ovarian cancer is spread within the family before actual genetic test results. Forty-two women (19 had a breast or ovarian tumor and 23 did not) were asked to fill out a questionnaire about: (1) the spread within the family of the medical information received during the consultation; and (2) the reasons for sharing this information. Results indicate that all of the women socially shared medical information with an immediate family member for preventive purposes, and generally not for seeking emotional or informative social support.
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Mouret-Fourme E, Andrieu N, Chompret A, Caron O, Gauthier-Villars M, Stoppa-Lyonnet D, Fricker J, Lasset C, Bonadona V, Berthet P, Faivre L, Luporsi E, Frénay M, Gladieff L, Guimbaud R, Gesta P, Sobol H, Huiart L, Eisinger F, Longy M, Dugast C, Colas C, Coupier I, Pujol P, Lortholary A, Vennin P, Adenis C, Nguyen TD, Delnatte C, Chevrier A, Rossi A, Limacher J, Caron O, Bignon Y, Demange L, Dreyfus H, Cohen-Haguenauer O, Venat-Bouvet L, Zattara-Cannoni H, Bonaïti C, Noguès C. Estimation du risque de cancer du sein dans une cohorte prospective de femmes porteuses d’une mutation sur les gènes BRCA : cohorte nationale GENEPSO. Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.02.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Leroy T, Christophe V, Adenis C, Vanlemmens L, Vennin P. Familial transmission of information dealing with BRCA1/2 mutations in hereditary breast and ovarian cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #1104
Background: A mutation of the BRCA1/2 genes is implicated in 5 to 10% of the breast and ovarian cancer cases. In France, when such a genetic mutation is discovered in a family, the consulting persons are expected to transmit themselves this medical information to their relatives. Indeed, for legal reasons, physicians are not allowed to contact them personally. An important gap has been observed however between the number of persons who are potentially concerned by this genetic information and the number of persons actually consulting. We then wondered about (1) the actual transmission of genetic information to relatives, (2) possible reasons for the non-transmission of this information, (3) the rate of concerned consulting relatives and (4) presumed reasons for not consulting when informed.
 Methods: This sample includes 31 target consultants (index cases) of mutated families who received the result of the genetic test between January 2003 and June 2005. Data were gathered in two successive steps: some were first referring to consultants' medical files, then we called these target consultants asking them standardized questions about their relatives. Final analyses concern 264 relatives complying with our selection criteria.
 Results: According to information gathered thanks to medical files and calls to target consultants, most of the relatives (73.1 %) are informed that a deleterious mutation is present in the family. Women are more often informed (80.7 %) than men (63.2 %). The non-informational motives are on the one hand mainly social and emotional distance and, on the other hand, the stressful content of this information. It would be disclosed through family by the women who are alive and carry the mutation. Moreover, a minority of the presumed informed women (39.7 %) have attended the oncogenetic consultation. This rate represents 32 % of all concerned women. Almost no man has consulted. We can just assume the motives for short-term absence of consultation. They seem to be especially linked to relatives' disinterest towards genetic information. The studied characteristics just allow us to point out the closeness with a mutated relative as a determinant factor of consultation.
 Discussion: This study brings two main results linked to relatives' information and consultation when a breast and ovarian cancer genetic risk has been identified in the family. On the first hand, it confirms that familial transmission of the medical information is pretty good. On the other hand, despite the good communication among family members, the rate of consultation remains low in informed women. According to these findings, efforts have to be made to give better explanations about the goals of oncogenetic consultation as well as enhancing the quality of information transmission in mutated families. These improvements could raise consultation rates and then increase the efficiency of screening and preventive measures.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1104.
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Affiliation(s)
- T Leroy
- 1 URECA EA 1059 - Staff FASE (Family, Health, Emotion), University of Lille 3, Villeneuve d Ascq, France
| | - V Christophe
- 1 URECA EA 1059 - Staff FASE (Family, Health, Emotion), University of Lille 3, Villeneuve d Ascq, France
| | - C Adenis
- 2 Department of Senology, Oscar Lambret Centre, Lille, France
| | - L Vanlemmens
- 2 Department of Senology, Oscar Lambret Centre, Lille, France
| | - P Vennin
- 2 Department of Senology, Oscar Lambret Centre, Lille, France
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Ceugnart L, Taieb S, Vennin P, Giard S, Chauvet MP, Chaveron C, Bachelle F, Faivre-Pierret M, Rocourt N, Bercez H, Fauquet I. [Role of MRI in the presurgical work-up of breast cancer: appropriate utilization of MRI as a complement to mammography and ultrasound]. J Radiol 2008; 89:1774-1779. [PMID: 19106838 DOI: 10.1016/s0221-0363(08)74486-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The role of MRI for presurgical local staging of breast cancers amenable to conservative treatment has been the subject of multiple publications and tends to become a "validated" indication in routine practice. The purpose of the paper is to review the advantages and limitations of this imaging modality that is part of a comprehensive management that must be validated by clinical data especially with regards to local recurrence and survival. Knowledge of these elements combined with more precise indications should result in improved patient management while avoiding overtreatment or unnecessary anxiety-producing examinations.
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Affiliation(s)
- L Ceugnart
- Département d'imagerie, Centre Régional de Lutte Contre le Cancer Oscar Lambret, 3, rue Frédéric Combemale, 59000 Lille.
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Vennin P, Belkacémi Y, Chauvet MP. [Follow-up of patients treated for localized invasive breast carcinoma]. Gynecol Obstet Fertil 2008; 36:183-189. [PMID: 18255329 DOI: 10.1016/j.gyobfe.2007.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Accepted: 11/29/2007] [Indexed: 05/25/2023]
Abstract
The follow-up of patients treated for invasive breast carcinoma remains a major challenge because of breast cancer prevalence and the frequent patient's preferences for a regular follow-up. Concerning this last point, there is a lack of studies about the consequences of a systematic follow-up. Few decades ago, regular and systematic follow-up was considered as a dogma. In 1994, it was seriously questioned by two randomised Italian trials: they did not find any benefit in terms of survival and quality of life in patients who had a regular search of asymptomatic metastasis. Follow-up strategy after early breast cancer is still an unexplored field, despite higher performance of investigation tests and development of new treatments strategies that allowed a significant decrease of recurrences and increase of cancer care. Currently, the international guidelines deeply recommend a regular physical examination and mammography. But a systematic search for non-symptomatic metastases is unnecessary. We now need a coordination between practitioners to avoid useless tests, and to respond to patients' will.
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Affiliation(s)
- P Vennin
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, B.P. 307, 59020 Lille cedex, France.
| | - Y Belkacémi
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, B.P. 307, 59020 Lille cedex, France; Département universitaire de radiothérapie-oncologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, B.P. 307, 59020 Lille cedex, France; Faculté de médecine, université de Lille-II, 59020 Lille cedex, France
| | - M-P Chauvet
- Département de sénologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, B.P. 307, 59020 Lille cedex, France
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Julian-reynier C, Eisinger F, Chabal F, Aurran Y, Bignon YJ, Machelard-roumagnac M, Maugard C, Noguès C, Vennin P, Sobol H. Cancer genetic consultation and anxiety in healthy consultees. Psychol Health 2007. [DOI: 10.1080/08870449908407335] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vennin P. [Informed consent or choice? An ethical dilemma in oncology practice]. Bull Cancer 2007; 94:453-9. [PMID: 17535783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 03/16/2007] [Indexed: 05/15/2023]
Abstract
How articulate information, mutidisciplinary practice, choice and decision of the treatment in a good patient-doctor relationship, an ethical relationship ? Doctor is an expert who gets the information (patients have more and more others sources of information). Choice of the treatment depends of the facts (the evidence) and personal values (the preferences). The selection between the different options (most often they are several options) may be done by the physician or by physicians in a multidisciplinary clinics, in the presence of the patient or not. The final decision to do or not the treatment belongs to the patient (who is not always aware of that). Initial sharing of the information between patient and doctor may permit the patient to choose himself the best option. More complete is sharing of the information, more the patient is able to do a free choice (without the influence of the doctor). It is often possible (genetics, prevention, screening, adjuvant treatments) to share in full the available information (knowing its relativity and limits). In oncology, the full sharing of the information is not always realistic, neither asked by the patient. Nevertheless, it is possible to go progressively with the patient to a preferred choice through a deliberative process, a co-construction of the decision. But often, the doctor refer to a pre-established protocol, build by physicians, representing the choice of the majority (doctors and/or patients) in the "same" situation. Only one option is offered to the patient from whom consent is asked, the information been then delivered to explain the choice already done. This paternalistic attitude is very effective, comfortable and don't alter the satisfaction of the majority of the patients, however, it limits the patient's autonomy. The patient is not allowed to choose between all the possibilities but accept or refuse the doctor's choice. With the extreme variability of the situations, it would be illusive to defend a unique attitude. Doctor has yet to try to adapt himself to every single case.
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Affiliation(s)
- Philippe Vennin
- Centre Oscar Lambret, rue Frédéric-Combemale, BP 307, 59020 Lille.
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20
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Vennin P, Taïeb S, Ceugnart L. Dépistage des cancers du sein. Pas si simple. Imagerie de la Femme 2007. [DOI: 10.1016/s1776-9817(07)88601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Hoarau H, Kerbrat P, Lesoin A, Lhommé C, Luporsi E, Philip T, Querleu D, Saltel P, Thomas L, Vennin P, Véron M, Voigt JJ. [Patient information booklet SOR SAVOIR PATIENT: understanding ovarian cancer, a guide for cancer patients and family members]. Gynecol Obstet Fertil 2006; 34:1195-204. [PMID: 17137822 DOI: 10.1016/j.gyobfe.2006.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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22
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Mancini J, Noguès C, Adenis C, Berthet P, Bonadona V, Chompret A, Coupier I, Eisinger F, Fricker JP, Gauthier-Villars M, Lasset C, Lortholary A, N'Guyen TD, Vennin P, Sobol H, Stoppa-Lyonnet D, Julian-Reynier C. Patients' characteristics and rate of Internet use to obtain cancer information. J Public Health (Oxf) 2006; 28:235-7. [PMID: 16809788 DOI: 10.1093/pubmed/fdl019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to present baseline data on the access to Internet by French breast cancer patients attending genetic clinics and to examine factors affecting Internet health-related use. Twenty-four percent of participants used Internet to obtain information about the disease. This rate was higher among patients with health occupations [adjusted odds ratio (adjOR) 2.6; 95% confidence interval (CI) 1.3-5.1], the most highly educated (adjOR 2.1; 95% CI 1.1-4.0) and those under 41 years of age (adjOR 7.3; 95% CI 2.1-26.2). Almost one of every three women was dissatisfied of this source of information.
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Affiliation(s)
- Julien Mancini
- INSERM UMR379, Epidemiology and Social Sciences Unit, Institut Paoli-Calmettes, 232 Bd Ste Marguerite, F-13273 Marseille cedex 09, France
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Mancini J, Noguès C, Adenis C, Berthet P, Bonadona V, Chompret A, Coupier I, Eisinger F, Fricker JP, Gauthier-Villars M, Lasset C, Lortholary A, N'Guyen TD, Vennin P, Sobol H, Stoppa-Lyonnet D, Julian-Reynier C. Impact of an information booklet on satisfaction and decision-making about BRCA genetic testing. Eur J Cancer 2006; 42:871-81. [PMID: 16563745 DOI: 10.1016/j.ejca.2005.10.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Revised: 10/24/2005] [Accepted: 10/25/2005] [Indexed: 11/25/2022]
Abstract
The aim of this study was to assess the impact of a standardized patient information booklet on decisions women make about genetic testing. This French national multi-centre survey included all women with cancer to whom genetic testing for BRCA1/2 mutation had been proposed. The control group was surveyed before the booklet became available (n = 263), and the experimental group, after being given it personally (n = 297). After multivariate adjustment, the booklet had a positive impact on satisfaction with the information provided (Odds ratio (OR) = 2.9; 99% confidence interval (CI) = 1.7-5.0; P = 0.001), decreased the decisional conflicts due to lack of information (OR = 1.9; 99% CI = 1.1-3.3; P = 0.002), and had a marginal impact on knowledge (R2-gain = 3%; P = 0.001). The women in the experimental group decided more frequently to undergo testing (99% vs. 95%; P = 0.009). In addition to a consultation providing more tailored information, a standardized written document improved the decision-making process involved in giving informed consent to genetic testing.
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Affiliation(s)
- Julien Mancini
- INSERM, UMR379, Institut Paoli-Calmettes, Epidemiology and Social Sciences Unit, 232 Bd Ste Marguerite, Marseille F-13000, France
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Mancini J, Nogues C, Chompret A, Cypowyj C, Fricker J, Bonadona V, Lortholary A, N’Guyen T, Sobol H, Stoppa-Lyonnet D, Vennin P, Julian-Reynier C. P17-7 Impact d’un livret d’information sur les connaissances, la satisfaction et la décision de demander un test génétique. Rev Epidemiol Sante Publique 2004. [DOI: 10.1016/s0398-7620(04)99385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Eisinger F, Stoppa-Lyonnet D, Lasset C, Vennin P, Chabal F, Noguès C, Moatti JP, Sobol H, Julian-Reynier C. Comparison of physicians' and cancer prone women's attitudes about breast/ovarian prophylactic surgery. Results from two national surveys. Fam Cancer 2004; 1:157-62. [PMID: 14574172 DOI: 10.1023/a:1021113715998] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Prophylactic surgery is a major issue for breast/ovarian cancer prone women. Bio-clinical data to help in the decision-making are not sufficient. In this context of uncertainty, physicians' and women's attitudes to prophylactic surgery is information of great value. The physicians' attitudes were assessed by a randomised national sample of practitioners involved in breast and ovarian cancer management. The patients' attitudes were appraised with a pre-consultation self- administered questionnaire presented during a one-year period to all women in five cancer genetic clinics chosen, for their representative geographical locations and their activity level. Consent to prophylactic surgery is higher among physicians than among patients (p < 0.0001). Acceptability of mastectomy is lower than that of oophorectomy in both patients and physicians (p < 0.0001 in both groups). In addition, age at which the intervention is proposed to be performed is a key determinant for both mastectomy and oophorectomy acceptability, in both physicians and patients (p < 0.001 for each comparison). Particularly, the age of 40 years seems to be a critical threshold for the acceptability of prophylactic oophorectomy. In contrast, respondents' age at the time of the survey has no significant effect on the acceptability rate. The higher acceptability rate of prophylactic oophorectomy compared to that of mastectomy observed in the physicians' survey is paradoxical because a more substantial medical impact on life expectancy was expected from the latter. Our results indicate that assumed reduced mortality is not the main criterion steering acceptability. It was anticipated that prophylactic mastectomy should be rarely performed in France.
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Dilhuydy JM, Luporsi E, Leichtnam-Dugarin L, Vennin P, Hoarau H. [Radiotherapy of breast cancer]. Cancer Radiother 2003; 7:213-21. [PMID: 12834780 DOI: 10.1016/s1278-3218(03)00038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Huiart L, Eisinger F, Stoppa-Lyonnet D, Lasset C, Noguès C, Vennin P, Sobol H, Julian-Reynier C. Effects of genetic consultation on perception of a family risk of breast/ovarian cancer and determinants of inaccurate perception after the consultation. J Clin Epidemiol 2002; 55:665-75. [PMID: 12160914 DOI: 10.1016/s0895-4356(02)00401-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to assess the effects of cancer genetic consultations on women's perception of their family risk of breast/ovarian cancer, and to determine which factors were associated with an inaccurate perception after the consultation. A multicenter prospective survey was carried out on women (n = 397) attending cancer genetic clinics in France for the first time, in which the perceived family risk was measured both before and after the consultation, using self-administered questionnaires. The effects of the consultation on risk perception were significant among low (P <.001) and moderate risk women (P <.05). However, after the consultation, 76.3% of the "low"-risk women did not perceive their family as "low"-risk families, and 21.9% of the moderate-risk women were still definitely sure there was a genetic risk running in their family. The consultation did not affect the family risk perception of the high risk women (n = 171): the risk was thought to be very high both before (87.7%) and after (89.5%) the consultation (NS); however 10.5% of this group still perceived their family as being unlikely to be at risk after the consultation. In the low- and moderate-risk groups after multivariate adjustment, the inaccurate perceptions varied, depending on the clinics and on the psychosocial context of the consultation: they increased when the consultee was personally affected by cancer, and decreased when the consultee had a health occupation. Cancer genetic consultations had only marginal effects on the perception of family risk on the whole, although they were significant in the case of low- and moderate-risk women. The question arises as to whether a more comprehensive approach should be implemented and how to go about providing efficient cancer risk information in the context of health care systems.
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Affiliation(s)
- Laetitia Huiart
- Epidemiology and Social Sciences Unit (INSERM U379), Institut Paoli-Calmettes, 232 Bd Ste Marguerite, 13273 Marseille cedex 09, France
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28
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Misset JL, Vennin P, Chollet PH, Pouillart P, Laplaige PH, Frobert JL, Castera D, Fabro M, Langlois D, Cortesi E, Lucas V, Gamelin E, Laadem A, Otero J. Multicenter phase II-III study of oxaliplatin plus cyclophosphamide vs. cisplatin plus cyclophosphamide in chemonaive advanced ovarian cancer patients. Ann Oncol 2001; 12:1411-5. [PMID: 11762813 DOI: 10.1023/a:1012556627852] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE A phase II-III randomised study to compare safety and efficacy of an oxaliplatin/cyclophosphamide (OXAC) combination, vs. the reference combination of cisplatin/cyclophosphamide (CPC), in untreated advanced ovarian cancer patients. PATIENTS AND METHODS 182 patients were enrolled, of whom 177 were treated: 86 with OXAC (130 mg/m2 oxaliplatin two-hour intravenous (i.v.) infusion, 1,000 mg/m2 cyclophosphamide two-hour i.v. infusion), and 91 with CPC (100 mg/m2 cisplatin one-hour i.v. infusion. 1,000 mg/m2 cyclophosphamide two-hour i.v. infusion). Treatment cycles were repeated every three weeks (maximum of six cycles). RESULTS The main toxicities, which were significantly less severe in the OXAC arm, were myelosuppression and vomiting, including (OXAC vs CPC, % patients): grade 3-4 leukopenia (37% vs. 56%), and anaemia (7% vs. 32%), with blood transfusions in 8% vs. 21%. In the OXAC arm, 64% of surgically assessable patients and 33% of clinically assessable patients achieved an objective response. In the CPC arm, 67% patients achieved a surgical response and 42% achieved an objective clinical response. In the OXAC and CPC arms, median progression free-survival was 13.0 and 13.3 months, and overall survival was 36.0 and 25.1 months respectively, without statistically significant difference. CONCLUSION The activity and time-related parameters of the OXAC and CPC combinations in advanced ovarian cancer patients, are comparable. Combined with the better safety profile of the oxaliplatin-containing regimen, this confirms the interest of oxaliplatin combined with active new agents in this indication.
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Affiliation(s)
- J L Misset
- Fédération des Services des Maladies Sanguines Immunitaires et Tumorales, Hĵpital Paul Brousse, Villejuif, France.
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29
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Taïeb S, Vennin P. [Evidence-based medicine: towards evidence-based radiology]. J Radiol 2001; 82:887-90. [PMID: 11604683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
PURPOSE To present evidence-based medicine (EBM), a concept that has been emerging over the decade, and to propose a reflexion about the role of radiologists in this new paradigm of medical practice. Clinical decision making. This new paradigm proposes the use of the best evidence and patient's participation in making medical decisions with de-emphasizing of intuition and empirical medicine. Application to a practice policy. EBM imposes new skills for physicians: clinical practice guideline is a witness of its importance. The main objective of EBM is to assist practitioners in their decision making process, but limits of this new concept must be known when it is used to control health-care resources or practice policies. Towards evidence-based radiology. What is the place for radiologists (diagnosis or interventional) in this new very popular paradigm?
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Affiliation(s)
- S Taïeb
- Département de Radiologie, Centre Oscar Lambret, 3, rue Frederic Combemale, BP 307, 59020, Lille Cedex, France.
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30
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Gore M, ten Bokkel Huinink W, Carmichael J, Gordon A, Davidson N, Coleman R, Spaczynski M, Héron JF, Bolis G, Malmström H, Malfetano J, Scarabelli C, Vennin P, Ross G, Fields SZ. Clinical evidence for topotecan-paclitaxel non--cross-resistance in ovarian cancer. J Clin Oncol 2001; 19:1893-900. [PMID: 11283120 DOI: 10.1200/jco.2001.19.7.1893] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A large, randomized study comparing the efficacy and safety of topotecan versus paclitaxel in patients with relapsed epithelial ovarian cancer showed that these two compounds have similar activity. In this study, a number of patients crossed over to the alternative drug as third-line therapy, ie, from paclitaxel to topotecan and vice versa. We therefore were able to assess the degree of non-cross-resistance between these two compounds. PATIENTS AND METHODS Patients who had progressed after one platinum-based regimen were randomized to either topotecan (1.5 mg/m(2)/d) x 5 every 21 days (n = 112) or paclitaxel (175 mg/m(2) over 3 hours) every 21 days (n = 114). A total of 110 patients received cross-over therapy with the alternative drug (61 topotecan, 49 paclitaxel) as third-line therapy. RESULTS Response rates to third-line cross-over therapy were 13.1% (8 of 61 topotecan) and 10.2% (5 of 49 paclitaxel; P =.638). Seven patients who responded to third-line topotecan and four patients who responded to paclitaxel had failed to respond to their second-line treatment. Median time to progression (from the start of third-line therapy) was 9 weeks in both groups, and median survival was 40 and 48 weeks for patients who were receiving topotecan or paclitaxel, respectively. The principal toxicity was myelosuppression; grade 4 neutropenia was more frequent with topotecan (81.4% of patients) than with paclitaxel (22.9% of patients). CONCLUSION Topotecan and paclitaxel have similar activity as second-line therapies with regard to response rates and progression-free and overall survival. We demonstrated that the two drugs have a degree of non-cross-resistance. Thus, there is a good rationale for incorporating these drugs into future first-line regimens.
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Affiliation(s)
- M Gore
- Royal Marsden Hospital, London, UK.
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31
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Vennin P, Taïeb S, Carpentier P. [Patient choice for cancer treatment: towards a shared-decision model?]. Bull Cancer 2001; 88:391-7. [PMID: 11371373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
The process of medical decision implies the elaboration of a choice between alternatives. Who has the choice? The doctor? The patient? Both? That depends on the particular characteristics of the patient and of the tumour, but also of the characteristics of the doctor and of his approach of medical discipline. For that reason, we planned first to remind some principles. In our analysis, the patient-doctor's relationship ties with environment, culture and habits. Philosophical principles, moral, and models of the relation between patient and doctor concern first part. In the second part, these ideas are compared with our routine practice: surveys about patients' needs, the obstacles for complete information and participation, studies on patients' preferences. The authors' analysis is that we are going inescapably towards shared decision-making taking into account the patients preferences. This evolution is not only tied with ethical principles, but with medical reason, i.e. the variability of patients' preferences led to tailor the treatment to the individual patient especially when benefit is limited. Of course, the applicability of a shared model depends on the particular situation of the patient and of his demand. It is all the easier as the consequences of the treatment are well known the riks tiny and distant. In the classical paternalistic model, there is no choice for the patient because the doctor(s) give the treatment. In the ideal model of the shared decision, doctor and patient progress together towards medical decision, in this case, the patient is not alone facing a choice, and in all cases, he is never alone.
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Affiliation(s)
- P Vennin
- Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 309, 59020 Lille Cedex
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32
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Vennin P, Taïeb S, Carpentier P. [About standard: from rule to patient. Breast cancer as an example]. Bull Cancer 2001; 88:221-2. [PMID: 11257598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- P Vennin
- Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille Cedex
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33
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Vennin P. [Standards, Options and Recommendations (SOR) on hormone therapy in nonmetastatic cancer of the breast]]. Bull Cancer 2000; 87:948-50. [PMID: 11174127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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34
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Delozier T, Spielmann M, Macé-Lesec'h J, Janvier M, Hill C, Asselain B, Julien JP, Weber B, Mauriac L, Petit JC, Kerbrat P, Malhaire JP, Vennin P, Leduc B, Namer M. Tamoxifen adjuvant treatment duration in early breast cancer: initial results of a randomized study comparing short-term treatment with long-term treatment. Fédération Nationale des Centres de Lutte Contre le Cancer Breast Group. J Clin Oncol 2000; 18:3507-12. [PMID: 11032592 DOI: 10.1200/jco.2000.18.20.3507] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In 1986, The Fédération Nationale desCentres de Lutte Contre le Cancer Breast Group initiated a multicenter randomized trial to assess the usefulness of long-term adjuvant tamoxifen treatment. Short-term adjuvant tamoxifen treatment was to be compared with life long adjuvant tamoxifen treatment. PATIENTS AND METHODS Patients who were disease-free after 2 to 3 years of adjuvant tamoxifen treatment were eligible for the trial. From September 1986 to May 1995, 3,793 patients were randomized from France, Belgium, and Argentina. A total of 1,882 patients stopped tamoxifen (short-term group), and 1,911 patients were to continue tamoxifen for life (long-term group) at the same dose as previously prescribed. The protocol was modified in February 1997, limiting tamoxifen treatment to 10 years after randomization, thus giving a comparison between a 2- to 3-year treatment and a 12- to 13-year treatment. To date, the median duration of tamoxifen treatment is 30 months in the short-term group, and 70 months in the long-term group. RESULTS Overall, longer tamoxifen treatment induced a 23% reduction in relapse rates, leading to a 7-year disease-free survival rate of 78%, compared with 72% in the shorter-treatment group. In contrast, overall survival did not differ between the two groups, with a 79% overall survival rate in both groups. This improvement in disease-free survival could be observed in node-positive patients (P: =.001); however, it was not found in node-negative patients. Prolonged tamoxifen treatment corresponded to a significant increase in disease-free survival in estrogen receptor-positive patients (P: =.03) as well as in estrogen receptor-negative patients (P: =.05). Furthermore, longer treatment reduced contralateral breast cancers and did not increase the number of endometrial cancers. CONCLUSION Although no survival advantage was noted, patients did benefit from longer tamoxifen treatment over 3 years and had significantly better disease-free survival compared with patients who stopped hormonal treatment. Long-term follow-up is needed to assess these results. Most patients in the long-term group are still receiving treatment. Comparison of results as time passes will enable conclusions to be made on the value of long-term treatment over 5 years compared with 2 to 3 years.
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Affiliation(s)
- T Delozier
- Fédération Nationale des Centres de Lutte Contre le Cancer, Paris, France.
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35
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Taïeb S, Leblanc E, Bonodeau F, Vennin P, Fournier C, Besson P. [Predictive value of abdominopelvic scan for optimal surgery of ovarian carcinoma]. J Gynecol Obstet Biol Reprod (Paris) 2000; 29:555-63. [PMID: 11084462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Some patients undergo laparoscopy without optimal debulking surgery as initial treatment for advanced ovarian carcinoma. The amount of residual tumor following primary surgery is an important prognosis factor. Neoadjuvant chemotherapy is a new therapeutic approach. Secondary, optimal surgery could be done in better conditions. PURPOSE To access the ability of preoperative abdominopelvic CT to predict success of debulking surgery for ovarian carcinoma: less than 1cm of residual tumor size after initial surgery. MATERIALS AND METHODS We reviewed 39 patients (two stage Ic, 1 stage IIc, 22 stage III and 14 stage IV) operated on for ovarian carcinoma between January 1992 and December 1997. Surgical criteria of inability to perform optimal surgical cytoreduction were compared with abdominopelvic CT done the month before. CT scans were prospectively assessed by radiologist A and retrospectively (3 months to 6 years delay) reviewed separately by radiologists A and B without surgical data. RESULTS Nineteen patients underwent optimal debulking surgery: 13 no residual tumor and 6 with residual lesions under 1cm. The interreader (0.73) and intrareader (0.9) agreement, worked out by Kappa coefficient, was judged good to very good. The sensitivity of CT was 91% with a specificity of 95%. CONCLUSION These results allowed us to determine which CT criteria were accurate and reproducible to be a helpful for therapeutic choice and to avoid laparotomy without optimal surgery.
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Affiliation(s)
- S Taïeb
- Départements de Radiologie, Centre Oscar-Lambret, Lille, France
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36
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Kolesnikov-Gauthier H, Carpentier P, Depreux P, Vennin P, Caty A, Sulman C. Evaluation of toxicity and efficacy of 186Re-hydroxyethylidene diphosphonate in patients with painful bone metastases of prostate or breast cancer. J Nucl Med 2000; 41:1689-94. [PMID: 11037999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
UNLABELLED Twenty-eight patients (12 men with prostate cancer, 16 women with breast cancer) were included in a phase II trial to evaluate the efficacy of 186Re-hydroxyethylidene diphosphonate (HEDP) on pain from bone metastasis and the toxicity of this agent. METHODS After intravenous administration of 1295 MBq 186Re-HEDP, the efficacy was evaluated by means of a daily log. RESULTS We observed an objective response in 67% of prostate cancer patients and in 36% of breast cancer patients. The mean duration of response was 45 d for prostate cancer patients and 24 d for breast cancer patients. No major adverse effects were observed. Marrow toxicity did not exceed grade 2 for white blood cells and grade 3 for platelets using National Cancer Institute criteria. CONCLUSION 186Re-HEDP provides safe symptomatic relief of pain in prostate cancer patients. The benefit of this treatment is less clear in breast cancer patients. Further studies should be conducted to evaluate treatment by 186Re-HEDP at an earlier stage of the disease.
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37
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Julian-Reynier C, Eisinger F, Chabal F, Lasset C, Noguès C, Stoppa-Lyonnet D, Vennin P, Sobol H. Disclosure to the family of breast/ovarian cancer genetic test results: patient's willingness and associated factors. Am J Med Genet 2000; 94:13-8. [PMID: 10982476 DOI: 10.1002/1096-8628(20000904)94:1<13::aid-ajmg4>3.0.co;2-t] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Informed probands are key actors for disclosing genetic information to their relatives when a mutation has been identified in the family. The objectives were to study women's attitudes towards the family disclosure of positive breast cancer genetic testing results and to determine the predictive factors of the diffusion patterns observed. A national multi-center cross-sectional survey was carried out at five French cancer genetic clinics during a 1-year period. Self-administered questionnaires were completed after the consultation by 84.5% (398/471) of women attending breast cancer genetic clinics for the first time. Among the 383 respondents who had at least one living first-degree relative to inform, 8.6% would inform none, 33.2% would inform at least one of them, and 58.2% would inform all of them. The sibship would be the most frequently informed blood relatives, sisters in 86.9% and brothers in 79% compared with mother in 71.4%, children in 70.4%, and father in 64.9%. Women of the family would be more frequently informed than men (P < 0.05). After multivariate adjustment, age, the fact to be affected by cancer, the number of daughters, and the emotional disturbance due to cancer in a close relationship were the main determinants (P < 0.05) of the diffusion patterns observed. The first step of the relatives' attendance to genetic counseling and the proband's willingness to disclose breast cancer genetic tests results was high in this study and was clearly dependent on the women's personal and emotional characteristics.
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Affiliation(s)
- C Julian-Reynier
- Epidemiology and Social Sciences Unit, Institut National de la Santé et de la Recherche Médicale (INSERM U379), Marseille, France.
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Abstract
Early stage epithelial ovarian carcinoma is defined pathologically as a tumor strictly limited to one or both ovaries without any extra-ovarian disease (i.e., Stage IA or B of the International Federation of Gynecology and Obstetrics (FIGO) classification). This diagnosis can be obtained only after an exhaustive surgical staging procedure, performed as soon as the diagnosis of epithelial invasive ovarian carcinoma is established. This staging surgery currently encompasses a peritoneal cytology, the thorough inspection of all the visceral and parietal peritoneal surfaces with biopsy of any abnormality, total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO), random peritoneal biopsies, omentectomy, appendectomy and bilateral pelvic and para-aortic lymphadenectomies, up to the left renal vein. The results of this staging procedure and its indications are discussed. In all of the cases, the radical removal of the pathologic adnexa is indicated, along with the complete peritoneal and retroperitoneal staging. While fertility-sparing surgery (avoiding hysterectomy and contralateral adnexectomy, if possible) seems to be safe for young women, a TAH + BSO is the rule for the others. Adjuvant chemotherapy can be omitted in well-differentiated tumors with a negative staging operation, but currently it remains indicated in all other cases. Indeed, the ultimate goal in early stage ovarian carcinoma is to not impair by inadequate management the high chance of a cure.
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Affiliation(s)
- E Leblanc
- Departments of Senology and Gynecologic Oncology, Centre Oscar Lambret, Lille, France.
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39
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Taïeb S, Bonodeau F, Vennin P, Fournier C, Besson P. [Predictive value of preoperative abdominopelvic CT for optimal cytoreduction surgery in ovarian carcinoma]. Bull Cancer 2000; 87:265-72. [PMID: 10779815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Some patients underwent laparoscopy without optimal debulking surgery as initial treatment for advanced ovarian carcinoma. The amount of residual tumor following primary surgery was an important prognosis factor. Neoadjuvant chemotherapy is a new therapeutic approach. Secondary, optimal surgery could be done in better conditions. The purpose was to access the ability of preoperative abdominopelvic CT to predict success of debulking surgery for ovarian carcinoma: less than 1 cm of residual tumor size after initial surgery. We reviewed 39 patients (2 stages Ic, 1 stage IIc, 22 stages III and 14 stages IV) operated on for ovarian carcinoma between January 1992 and December 1997. Surgical criteria of inability to perform optimal surgical cytoreduction were compared with abdominopelvic CT done the month before. CT scans were prospectively assessed by radiologist A and retrospectively (3 months to 6 years delay) rewiewed separately by radiologists A and B without surgical data. Nineteen patients underwent optimal debulking surgery: 13 no residual tumor and 6 with residual lesions under 1 cm. The interreader (0.73) and intrareader (0.9) agreement, worked out by Kappa coefficient, was juged good to very good. The sensitivity of CT was 91% with a specificity of 95%. These results allowed us to determine wich CT criteria were accurate and reproducible to be a helpfull for therapeutic choice and to avoid laparotomy without optimal surgery.
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Affiliation(s)
- S Taïeb
- Département de radiologie, Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille Cedex, France.
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40
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Lhommé C, Vennin P, Callet N, Lesimple T, Achard JL, Chauvergne J, Luporsi E, Chinet-Charrot P, Coudert B, Couette JE, Guastalla JP, Lebrun D, Ispas S, Blumberg J. A multicenter phase II study with triptorelin (sustained-release LHRH agonist) in advanced or recurrent endometrial carcinoma: a French anticancer federation study. Gynecol Oncol 1999; 75:187-93. [PMID: 10525370 DOI: 10.1006/gyno.1999.5538] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this phase II multicenter study was to assess the efficacy and tolerance of triptorelin (a sustained-release LHRH agonist) in advanced or recurrent endometrial cancer. A total of 101 monthly intramuscular injections were administered to 24 eligible patients (median number/patient = 3; range 1-12). Mainly due to progression, only 16 patients received 3 or more injections. Among the 23 evaluable patients, 1 complete and 1 partial response (response rate of 8.7%) and 5 disease stabilizations were observed, often of long duration, but never in an irradiated area or after progestogens treatment failure. Median survival for eligible patients was 7.2 months (range: 1-36 months). Only grade 1 toxicities possibly related to the treatment were observed in 4 patients. In conclusion, triptorelin was safe, well tolerated, and easily manageable, and the very low toxicity did not impair the quality of life in these patients with a very poor prognosis. Although the response rate was disappointing, several patients showed early evidence of efficacy which may be of long duration. Response rates range between 0 and 45% in different published studies. Additional studies with stricter inclusion criteria and a larger sample size are necessary to better evaluate the role of LHRH agonists in endometrial adenocarcinomas.
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Affiliation(s)
- C Lhommé
- Institut Gustave Roussy, Villejuif Cedex, France
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41
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Lhommé C, Fumoleau P, Fargeot P, Krakowski Y, Dieras V, Chauvergne J, Vennin P, Rebattu P, Roche H, Misset JL, Lentz MA, Van Glabbeke M, Matthieu-Boué A, Mignard D, Chevallier B. Results of a European Organization for Research and Treatment of Cancer/Early Clinical Studies Group phase II trial of first-line irinotecan in patients with advanced or recurrent squamous cell carcinoma of the cervix. J Clin Oncol 1999; 17:3136-42. [PMID: 10506610 DOI: 10.1200/jco.1999.17.10.3136] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the efficacy and tolerability of irinotecan (CPT-11) in advanced or recurrent cervical carcinoma. PATIENTS AND METHODS Eligible patients had histologically confirmed, inoperable, progressive, metastatic or recurrent squamous cell cervical carcinoma and had received no radiotherapy in the preceding 3 months and had never received chemotherapy. The initial irinotecan dosage of 350 mg/m(2) every 3 weeks was modifiable according to toxicity. Treatment continued for six cycles after complete response, or until disease progression or excessive toxicity after partial response, or for three additional cycles in the case of stable disease. Patients were stratified into group A (>/= one measurable lesion in a previously unirradiated area, with or without progressive disease in irradiated fields) or group B (measurable new lesion[s] in an irradiated field). RESULTS Fifty-one of 55 enrolled patients were eligible for inclusion (median age, 47 years; range, 30 to 71 years). The response rate was 15.7% (95% confidence interval [CI], 7.0% to 28.6%) overall, 23.5% (95% CI, 10.7% to 41.2%) for group A (complete response, 2.9%), and zero for group B. The median time to progression and median survival were 4.0 and 8.2 months for group A and 2.5 and 4.2 months for group B, respectively. The major grade 3/4 toxicities for groups A and B were diarrhea (24.3% and 55.5%, respectively) and neutropenia (24.3% and 33.3%, respectively). There were four toxicity-related deaths, three in group B. Patients with no prior external pelvic irradiation experienced fewer grade 3 and 4 adverse events. CONCLUSION Irinotecan is effective in treating cervical squamous cell carcinoma if disease is located in an unirradiated area. Because of toxicity, a reduced dose is advised for patients previously treated with external pelvic irradiation.
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Affiliation(s)
- C Lhommé
- Institut G. Roussy, Villejuif, France.
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42
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Eisinger F, Noguès C, Guinebretière JM, Peyrat JP, Bardou VJ, Noguchi T, Vennin P, Sauvan R, Lidereau R, Birnbaum D, Jacquemier J, Sobol H. Novel indications for BRCA1 screening using individual clinical and morphological features. Int J Cancer 1999; 84:263-7. [PMID: 10371344 DOI: 10.1002/(sici)1097-0215(19990621)84:3<263::aid-ijc11>3.0.co;2-g] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Since there is a lack of common family profile among BRCA1-gene carriers, and since the risk of being a mutation carrier is not limited to women with a family history of breast or ovarian cancer, multivariate statistical analysis using the logistic-regression model was carried out, to discriminate between sporadic cases and BRCA1-breast cancers (BRCA1-BCs), especially when information about the family history of breast/ovarian cancer and ethnicity are irrelevant or unavailable, in order to offer specific medical treatment to this population. We examined 32 BRCA1-BCs selected at cancer genetic clinics and 200 consecutive controls without family history of breast cancer for age at onset and current morphological parameters. Following the multivariate analysis, 3 parameters only, namely, early age at cancer onset [odds ratio (OR) for each year = 1.16; p < 0.0001], estrogen-receptor negativity (OR = 5.7; p = 0.01) and poor differentiation (OR = 5; p = 0.03) were found significant factors for predicting BRCA1-carrier status. The expected impact in BRCA1 screening of our model was estimated using data on 5700 breast-cancer cases from a hospital-based registry. Only 50 and 15% of tumours with early age at onset below 35 years present one or the other 2 discriminant parameters respectively. Consequently, whereas the probability of finding a BRCA1 mutation is rated low (6.2%) when the sole criterion of early onset up to the age of 35 years is used, based on our model, in the sub-group of women with a tumor that is both estrogen-receptor-negative and poorly differentiated the mutation-detection rate is predicted to be above the 10% chance level recommended by the ASCO guidelines. This sub-group of women, representing about 1% of all breast-cancer cases in Western countries, consequently deserves to be tested.
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Affiliation(s)
- F Eisinger
- Department of Genetic Oncology/INSERM CRI 9703, Paoli-Calmettes Institute, Marseille, France
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Julian-Reynier C, Eisinger F, Chabal F, Aurran Y, Bignon YJ, Noguès C, Machelard M, Maugard C, Vennin P, Sobol H. Cancer genetic clinics: why do women who already have cancer attend? Eur J Cancer 1998; 34:1549-53. [PMID: 9893626 DOI: 10.1016/s0959-8049(98)00164-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cancer patients attend oncogenetic clinics so that the existence of a genetic risk can be checked and the relatives informed. The aim of this study was to describe the expectations of cancer patients about genetic counselling and their beliefs about the aetiology of their disease. A survey based on self-administered questionnaires before and after the consultation was carried out on 115 women with breast/ovarian cancer who attended one of the six French participating clinics. In 59 cases (51%), the consultees' expectations focused on the preventive options available and in 86 cases (75%) on their offspring; 87 (76%) found the consultation informative. On average, the women rated heredity and diet as lower risk factors (P < 0.05) after the consultation than before. Heredity, stress and the environment were thought to be more decisive than diet, smoking and alcohol. 34 patients who seemed unlikely to have a genetic risk in the consultant's opinion thought heredity to be less relevant (P < 0.05) after the consultation than before. At the time of the survey, cancer patients accounted for at least half of the consultees attending oncogenetic clinics in France. They need to have the clinical specificities of their disease and its medical management explained. They attend mainly for their offspring's sake, whereas healthy clients attend for their own sake.
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Affiliation(s)
- C Julian-Reynier
- INSERUM U379, Centre Régional de Lutte contre le Cancer, Marseille, France
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Adenis A, Vennin P, Hecquet B. [Information for patients with cancer of the colon: results of a survey of gastroenterologists, surgeons, and oncologists of the North region]. Bull Cancer 1998; 85:803-8. [PMID: 9817065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This regional survey was aimed to detect hypothetical variations in attitudes among truth telling in colon cancer by an anonymous questionnaire sent to the 290 gastroenterologists, surgeons and oncologists of the Northern France area. The answers were assessed as always (A), often (O), rarely and never. Diagnosis was revealed to the patient (whether or not he asked the question) or to his spouse in 83%, 40% and 93% of the cases, respectively. The diagnosis of diffuse metastasis was revealed (A + O) to the patient or to his spouse in 23% and 95% of the cases, respectively. Only 3% of the physicians told (A + O) the patient that his condition was incurable while this aspect was A + O revealed to the patient's spouse in 34% of the cases. Most of the time, the diagnosis of colon cancer was revealed by oncologists rather than by surgeons or gastroenterologists. Conversely the full truth was more commonly told to the family by surgeons and gastroenterologists than by oncologists. We found variation in attitudes towards truth telling in colon cancer which depend on the physician's specialty. It seems to us that the magnitude of the full truth told to the patient or his family in Northern France area, is somewhat intermediate between the attitude of doctors in Northern Europe and in Latin Mediterranean or Eastern Europe countries.
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Taïeb S, Bonodeau F, Leblanc E, Vennin P, Fournier C, Besson P. [X-ray computed tomography compared to surgery in cancer of the ovary]. Contracept Fertil Sex 1998; 26:I-VIII. [PMID: 9823697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Eisinger F, Julian-Reynier C, Stoppa-Lyonnet D, Vennin P, Lasset C, Noguès C, Sobol H. Breast and ovarian cancer prone women and prophylactic surgery temptation. J Clin Oncol 1998; 16:2573-5. [PMID: 9667284 DOI: 10.1200/jco.1998.16.7.2573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Julian-Reynier C, Eisinger F, Chabal F, Aurran Y, Bignon YJ, Nogues C, Machelard M, Maugard C, Vennin P, Sobol H. Time elapsing from cancer diagnosis and anxiety in women attending cancer genetic clinics. Oncol Rep 1998; 5:885-8. [PMID: 9625838 DOI: 10.3892/or.5.4.885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to investigate the effects of cancer genetic consultations on feelings of anxiety in women with breast/ovarian cancer. Among the 138 women attending six French clinics during a one-year period, 115 (83.3%) answered pre- and post-consultation questionnaires. The state anxiety score (Spielberger's STAI) was lower (paired t-test, p<0.001) after the consultation (34.7 9.4) than before (38.8 10.5). The time elapsing since cancer diagnosis (r=-0.28, p=0.007) was the main predictor of the decrease in anxiety. The patients consulting earlier after their cancer was diagnosed were more anxious before the consultation than those consulting later: whereas their anxiety states after the consultation were similar. The consultation effectively decreased the anxiety observed and the anxiety felt by cancer patients before the consultation may constitute an anticipatory stress response that should be investigated.
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Affiliation(s)
- C Julian-Reynier
- INSERM U379, Centre Regional de Lutte contre le Cancer, 13273 Marseille, Cedex 9, France
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Vennin P. [Evidence-based medicine (EBM)...an evidence?]. Bull Cancer 1998; 85:358-9. [PMID: 9752301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
The literature suggests that the frequency of Dupuytren's disease is ten times greater in diabetes than in the general population. We have studied 42 diabetic patients with a contracture of the palmar fascia. Dupuytren's contracture can be considered a complication of diabetes and of the local neurovascular changes since both are often associated. The contracture is usually not severe in diabetes, is nodular in form, and usually crushes the palmar surface of the long and ring fingers. It is usually well tolerated by the patients and surgery is rarely indicated, particularly in view of the advanced age of many patients. In caring for patients with Dupuytren's disease, surgeons should also rule out the presence of diabetes with appropriate test.
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Affiliation(s)
- P Fossati
- Service d'Endocrinologie et de Diabétologie, U.S.N. A, Lille
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Peyrat JP, Vennin P, Hornez L, Fournier J, Adenis C, Bonneterre J. Germline BRCA1 mutations in patients from 84 families with breast and/or ovarian cancers in northern France. Eur J Cancer Prev 1998; 7 Suppl 1:S7-12. [PMID: 10866029 DOI: 10.1097/00008469-199802001-00003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The BRCA1 gene modification is responsible for an autosomal dominant syndrome of inherited early onset breast and/or ovarian cancer. This gene is estimated to account for almost half of inherited breast cancers and three quarters of inherited breast/ovarian cancers. This suggests that about 1 in every 500 women may carry the BRCA1 mutation. The BRCA1 was isolated by positional cloning in 1994. More than 100 different mutations have been found in the germline of affected individuals. Using systematic sequencing, we looked at BRCA1 germline mutations in 84 patients treated at the Centre Oscar Lambret for breast and/or ovarian cancer who belonged to high-risk families. We found 39 mutations: 22 true mutations inducing modifications of the BRCA1 protein (BRCA1+), six mutations with unknown consequences on the BRCA1 protein, and eleven mutations corresponding to polymorphisms that had been described previously. All the BRCA1+ cases had a HPG3 tumour. The median age of discovery and the receptor positivity percentage are lower in hereditary breast cancer than in the standard population of the breast cancers treated in our centre. Conversely, most of the BRCA1+ patients are without node involvement. This shows that BRCA1 mutations are not always related to parameters thought to indicate a bad prognosis.
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Affiliation(s)
- J P Peyrat
- Laboratoire d'Oncologie Moléculaire Humain, Centre Oscar Lambret, Lille, France
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