Aims and objectives
Lifetime risk of developing breast cancer in women with family history of cancer is usually assessed by suitable risk models considering multiple risk factors,
and applied with the aid of different software programs (for instance BRCAPRO,
BOADICEA,
IBIS,
etc.).
Risk models take into account woman’s age and family history of breast or ovarian cancer,
and some of them consider also reproductive history and ethnicity [1].
In our Institution,
risk assessment is performed by genetic counselling aiming to select women to be referred for genetic test....
Methods and materials
The study was designed by selecting BRCA-mutated women under surveillance at our Institution between 2006 and 2017.
The surveillance program included annual US and MRI for young women (25-35 y),
and annual mammography,
US and MRI (FFDM+US+MRI) for any other age women.
The retrospective study was approved by the local institutional Review Board.
Women who underwent prophylactic mastectomy during the surveillance interval were excluded.
The overall outcomes of the surveillance program,
detection rate and recall rate,
were evaluated calculating the percentage of the number of...
Results
133 patients were recruited in the high-risk screening program; 7 of them were excluded a posteriori because of prophylactic mastectomy.
126 patients were considered in the retrospective analysis,
99 (78.6%) of them BRCA1 and 27(21.4%) BRCA2 mutated.
They attended a total number of 636 screening events,
where a screening event was defined as an attended annual imaging protocol,
including all the imaging modalities expected by the protocol (US+MRI for patients < 35 y and FFDM+US+MRI for patients >=35 y),
or part of them.
Mean age...
Conclusion
The annual screening surveillance program was effective in detecting cancers in high-risk women,
with a significant number of false positives and relatively high costs.
Additional follow-up events did not convey any additional clinical information,
and,
as such are not recommended.
Personal information
Francesca Caumo MD
Veneto Institute of Oncology (IOV),
IRCCS
via Gattamelata 64,
35128 Padua (Italy)
email:
[email protected]
References
Steven A Narod.(2011) Screening of women at high risk for breast cancer.
Preventive Medicine 53 (127-130)
Su Min Ha,
Eun Young Cha et al.
(2017) Association of BRCA Mutation types.
Imaging features and pathologic Findings in Patients with breast Cancer with BRCA1 and BRCA2 mutations.
AJR 209: 220-228
Hideko Yamahuchi ,
Chizuko NaKagawa et al.
(2017) Cost-effectiveness of surveillance and prevention strategies in BCRA1/2 mutation carriers.
Breast Cancer
E.Warner (2011) Impact of MRI surveillance and breast cancer detection in young womwn with BRCA mutations ....
