#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Diagnostics of Breast Cancer in High-Risk Women – Our Own Experience


Authors: M. Palacova 1;  M. Krásenská 1;  A. Ondračková 1;  K. Petrakova 1;  M. Schneiderová 3;  L. Foretová 2;  M. Navratilova 2;  D. Hanousková 2
Authors‘ workplace: Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno 1;  Oddělení epidemiologie a genetiky nádorů, Masarykův onkologický ústav, Brno 2;  Oddělení radiologie, Masarykův onkologický ústav, Brno 3
Published in: Klin Onkol 2012; 25(Supplementum): 96-98

Overview

Preventive oncology clinic of MMCI provides complex preventive care for women with high hereditary risk of breast and ovarian cancer due to germline mutations in BRCA1 and BRCA2 genes. Clinical follow-up is also provided to women with mutations in other genes causing a higher risk of different tumors, and also to women with increased lifetime empirical risk of breast cancer due to positive family history. Our clinic was established in 2000 and takes care for about 700 women. The goal of the clinic is to extend the life expectancy of these women to the level of the regular population. The risk of breast cancer can be reduced by prophylactic surgeries. Prophylactic mastectomy and oophorectomy are offered to women at a high risk. Other modality in breast cancer risk reduction is a chemoprevention by Tamoxifen. Most women accept only secondary prevention with the goal of the detection of breast cancer in clinical stage I, where the tumor is smaller than 1 cm and the risk of recurrence is less than 10%. The algorithm of prevention care was changed over the time and our diagnostic methods were improved by magnetic resonance imaging of breasts. During the 11 years of clinical follow-up 32 breast cancers in 31 women were detected. High risk women are examined every 6 month by physical examination, breast ultrasound and MRI plus mammography yearly.

Key words:
BRCA1 gene – BRCA2 gene – diagnostics – preventive therapy – surgery

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
20. 7. 2012

Accepted:
27. 7. 2012


Sources

1. Chen S, Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol 2007; 15(11): 1329–1333.

2. Macháčková E, Plevová P, Lukešová M et al. Genetická predispozice ke vzniku maligního nádoru prsu. Klin Onkol 2006; 19 (Suppl): 48–54.

3. Foretová L, Petráková K, Palácová M et al. Genetic Test­ing and Prevention of Hereditary Cancer at MMCI – Over 10 Years of Experience. Klin Onkol 2010; 22(6): 388–400.

4. Plevová P, Novotný J, Petráková K et al. Syndrom hereditárního karcinomu prsu a ovarií. Klin Onkol 2009; 22 (Suppl): S6–S11.

5. Hartmann LC, Sellers TA, Schaid DJ et al. Efficacy of bilateral prophylactic mastectomy in BRCA1 and BRCA2 gene mutation carriers. J Natl Cancer Inst 2001; 93(21): 1633–1637.

6. Dražan L. Profylaktická mastektomie a její indikace u rizikových žen. Klin Onkol 2006; 19 (Suppl): 97–100.

7. Metcalfe K, Gershman S, Lynch HT et al. Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. Br J Cancer 2011; 104(9): 1384–1392.

8. Eisen A, Lubinski J, Klijn J et al. Breast cancer risk following bilateral oophorectomy in BRCA1 and BRCA2 mutation carriers: an international case-control study. J Clin Oncol 2005; 23(30): 7491–7496.

9. Finch A, Beiner M, Lubinski J et al. Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 Mutation. JAMA 2006; 296: 185–192.

10. Fisher B, Costantino JP, Wickerham DL et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst 2005; 97(22): 1652–1662.

11. Warner E, Messersmith H, Causer P et al. Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med 2008; 148(9): 671–679.

12. Kriege M, Brekelmans CT, Boetes C et al. Magnetic Resonance Imaging Screening Study Group. Efficacy of MRI and Mammography for Breast-Cancer Screening in Women with a Familial or Genetic Predisposition. N Engl J Med 2004; 351(5): 427–437.

13. Scheuer L, Kauff N, Robson M et al. Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J Clin Oncol 2002; 20(5): 1260–1268.

14. Vasen HF, Tesfay E, Boonstra H et al. Early detection of breast and ovarian cancer in families with BRCA muta­tions. Eur J Cancer 2005; 41(4): 549–554.

15. Schneiderová M, Bartoňková H. Úloha magnetické rezonance v mammologické prevenci u žen s dědičným rizikem nádoru prsu. Klin Onkol 2006; 19 (Suppl): 91–96.

16. Kuhl C, Weigel S, Schrading S et al. Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial. J Clin Oncol 2010; 28: 1450–1457.

Labels
Paediatric clinical oncology Surgery Clinical oncology

Article was published in

Clinical Oncology

Issue Supplementum

2012 Issue Supplementum

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#