An international survey of surveillance schemes for unaffected BRCA1 and BRCA2 mutation carriers

被引:22
作者
Madorsky-Feldman, Dana [1 ]
Sklair-Levy, Miri [1 ]
Perri, Tamar [1 ]
Laitman, Yael [1 ]
Paluch-Shimon, Shani [2 ]
Schmutzler, Rita [3 ]
Rhiem, Kerstin [3 ]
Lester, Jenny [4 ]
Karlan, Beth Y. [4 ]
Singer, Christian F. [5 ]
Van Maerken, Tom [6 ]
Claes, Kathleen [6 ]
Brunet, Joan [7 ]
Izquierdo, Angel [7 ]
Teule, Alex [7 ]
Lee, Jong Won [8 ]
Kim, Sung-Won [9 ]
Arun, Banu [10 ]
Jakubowska, Anna [11 ]
Lubinski, Jan [11 ]
Tucker, Katherine [12 ]
Poplawski, Nicola K. [13 ,14 ]
Varesco, Liliana [15 ]
Bonelli, Luigina Ada [16 ]
Buys, Saundra S. [17 ]
Mitchell, Gillian [18 ]
Tischkowitz, Marc [19 ]
Gerdes, Anne-Marie [20 ]
Seynaeve, Caroline [21 ]
Robson, Mark [22 ]
Kwong, Ava [23 ,24 ]
Tung, Nadine [25 ]
Tessa, Nalven [25 ]
Domchek, Susan M. [26 ]
Godwin, Andrew K. [27 ]
Rantala, Johanna [28 ]
Arver, Brita [29 ]
Friedman, Eitan [1 ,30 ,31 ]
机构
[1] Sheba Med Ctr, Meirav Ctr, High Risk Clin, Tel Hashomer, Israel
[2] Sheba Med Ctr, Inst Oncol, Tel Hashomer, Israel
[3] Univ Hosp Cologne, CIO, Ctr Hereditary Breast & Ovarian Canc, Cologne, Germany
[4] Cedars Sinai Med Ctr, Samuel Oschin Comprehens Canc Inst, Womens Canc Program, Los Angeles, CA 90048 USA
[5] Med Univ Vienna, Gen Hosp, Dept Obstet & Gynecol, Vienna, Austria
[6] Ghent Univ Hosp, Ctr Med Genet, Ghent, Belgium
[7] Catalan Inst Oncol Canc Network, Hereditary Canc Program, Barcelona, Spain
[8] Univ Ulsan, Coll Med, Asan Med Ctr, Seoul, South Korea
[9] Daerim St Marys Hosp, Dept Surg, Seoul, South Korea
[10] Univ Texas MD Anderson Canc Ctr, Breast Med Oncol & Clin Canc Genet, Houston, TX 77030 USA
[11] Pomeranian Med Univ, Dept Genet & Pathol, Szczecin, Poland
[12] Prince Wales Hosp, Hereditary Canc Serv, Sydney, NSW, Australia
[13] South Australian Clin Genet Serv SA Pathol, Adult Genet Unit, Womens & Childrens Hosp Site, Adelaide, SA, Australia
[14] Univ Adelaide, Univ Dept Pediat, Adelaide, SA, Australia
[15] UOS Ctr Tumori Ereditari IRCCS San Martino, Genoa, Italy
[16] UOC Epidemiol Clin IRCCS San Martino, Genoa, Italy
[17] Univ Utah, Dept Med, Huntsman Canc Inst, Salt Lake City, UT 84112 USA
[18] BC Canc Agcy, Hereditary Canc Program, Vancouver, BC, Canada
[19] Univ Cambridge, Addenbrookes Hosp, Dept Med Genet, Cambridge CB2 2QQ, England
[20] Copenhagen Univ Hosp, Rigshosp, Clin Genet, Copenhagen, Denmark
[21] Erasmus MC Canc Inst, Rotterdam, Netherlands
[22] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
[23] Univ Hong Kong, Hong Kong Hereditary Breast Canc Family Registry, Pok Fu Lam, Hong Kong, Peoples R China
[24] Univ Hong Kong, Dept Breast Surg, Pok Fu Lam, Hong Kong, Peoples R China
[25] BIDMC Hematol Oncol, Boston, MA USA
[26] Univ Penn, Basser Ctr BRCA, Philadelphia, PA 19104 USA
[27] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA
[28] Karolinska Univ Hosp, Dept Clin Genet, Stockholm, Sweden
[29] Karolinska Univ Hosp, Dept Oncol, Stockholm, Sweden
[30] Chaim Sheba Med Ctr, Inst Human Genet, Susanne Levy Oncogenet Unit, IL-52621 Tel Hashomer, Israel
[31] Tel Aviv Univ, Sackler Sch Med, Ramat Aviv, Israel
关键词
BRCA1/BRCA2 mutation carriers; High-risk women; Early detection; Risk-reducing surgery; Surveillance schemes; REDUCING SALPINGO-OOPHORECTOMY; OVARIAN-CANCER RISK; BREAST-CANCER; HEREDITARY BREAST; COST-EFFECTIVENESS; FOLLOW-UP; WOMEN; MAMMOGRAPHY; REDUCTION; RECOMMENDATIONS;
D O I
10.1007/s10549-016-3805-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Female BRCA1/BRCA2 mutation carriers are at substantially increased risk for developing breast and/or ovarian cancer, and are offered enhanced surveillance including screening from a young age and risk-reducing surgery (RRS)-mastectomy (RRM) and/or salpingo-oophorectomy (RRSO). While there are established guidelines for early detection of breast cancer in high-risk women who have not undergone RRM, there are less developed guidelines after RRM. We evaluated the schemes offered before and after RRS in internationally diverse high-risk clinics. An e-mailed survey was distributed to high-risk clinics affiliated with CIMBA. Overall, 22 centers from 16 countries responded. Pre RRS surveillance schemes overwhelmingly included breast imaging (primarily MRI) from 18 to 30 years and clinical breast exam (CBE) at 6-12 month intervals. For ovarian cancer, all but 6 centers offered semiannual/annual gynecological exam, transvaginal ultrasound, and CA 125 measurements. Post RRM, most centers offered only annual CBE while 4 centers offered annual MRI, primarily for substantial residual breast tissue. After RRSO only 4 centers offered specific gynecological surveillance. Existing guidelines for breast/ovarian cancer detection in BRCA carriers are being applied pre RRS but are not globally harmonized, and most centers offer no specific surveillance post RRS. From this comprehensive multinational study it is clear that evidence-based, long-term prospective data on the most effective scheme for BRCA carriers post RRS is needed.
引用
收藏
页码:319 / 327
页数:9
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