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Moghadasi S, Grundeken V, Janssen LAM, Dijkstra NH, Rodríguez-Girondo M, van Zelst-Stams WAG, Oosterwijk JC, Ausems MGEM, Oldenburg RA, Adank MA, Blom EW, Ruijs MWG, van Os TAM, van Deurzen CHM, Martens JWM, Schroder CP, Wijnen JT, Vreeswijk MPG, van Asperen CJ. Performance of BRCA1/2 mutation prediction models in male breast cancer patients. Clin Genet 2017; 93:52-59. [PMID: 28589637 DOI: 10.1111/cge.13065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 02/27/2017] [Revised: 05/12/2017] [Accepted: 06/01/2017] [Indexed: 01/11/2023]
Abstract
To establish whether existing mutation prediction models can identify which male breast cancer (MBC) patients should be offered BRCA1 and BRCA2 diagnostic DNA screening, we compared the performance of BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm), BRCAPRO (BRCA probability) and the Myriad prevalence table ("Myriad"). These models were evaluated using the family data of 307 Dutch MBC probands tested for BRCA1/2, 58 (19%) of whom were carriers. We compared the numbers of observed vs predicted carriers and assessed the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) for each model. BOADICEA predicted the total number of BRCA1/2 mutation carriers quite accurately (observed/predicted ratio: 0.94). When a cut-off of 10% and 20% prior probability was used, BRCAPRO showed a non-significant better performance (observed/predicted ratio BOADICEA: 0.81, 95% confidence interval [CI]: [0.60-1.09] and 0.79, 95% CI: [0.57-1.09], vs. BRCAPRO 1.02, 95% CI: [0.75-1.38] and 0.94, 95% CI: [0.68-1.31], respectively). Myriad underestimated the number of carriers in up to 69% of the cases. BRCAPRO showed a non-significant, higher AUC than BOADICEA (0.798 vs 0.776). Myriad showed a significantly lower AUC (0.671). BRCAPRO and BOADICEA can efficiently identify MBC patients as BRCA1/2 mutation carriers. Besides their general applicability, these tools will be of particular value in countries with limited healthcare resources.
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Affiliation(s)
- S Moghadasi
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - V Grundeken
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - L A M Janssen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - N H Dijkstra
- Dutch Breast Cancer Research Group, Amsterdam, the Netherlands
| | - M Rodríguez-Girondo
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, the Netherlands
| | - W A G van Zelst-Stams
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - J C Oosterwijk
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - M G E M Ausems
- Department of Genetics, University Medical Centre, Utrecht, the Netherlands
| | - R A Oldenburg
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M A Adank
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, the Netherlands
| | - E W Blom
- Department Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M W G Ruijs
- Department of Clinical Genetics, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - T A M van Os
- Department of Clinical Genetics, Academic Medical Centre, Amsterdam, the Netherlands
| | - C H M van Deurzen
- Department of Pathology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - J W M Martens
- Department of Medical Oncology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - C P Schroder
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - J T Wijnen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Human Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - M P G Vreeswijk
- Department of Human Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - C J van Asperen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
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