TY - JOUR
T1 - Predictive factors for BRCA1/BRCA2 mutations in women with ductal carcinoma in situ
AU - Bayraktar, Soley
AU - Elsayegh, Nisreen
AU - Gutierrez Barrera, Angelica M.
AU - Lin, Heather
AU - Kuerer, Henry
AU - Tasbas, Tunc
AU - Muse, Kimberly I.
AU - Ready, Kaylene
AU - Litton, Jennifer
AU - Meric-Bernstam, Funda
AU - Hortobagyi, Gabriel N.
AU - Albarracin, Constance T.
AU - Arun, Banu
PY - 2012/3/15
Y1 - 2012/3/15
N2 - BACKGROUND: It is unclear whether women with ductal carcinoma in situ (DCIS), like their counterparts with invasive breast cancer, warrant genetic risk assessment and testing on the basis of high-risk variables. The authors of this report identified predictive factors for mutations in the breast cancer-susceptibility genes BRCA1 and BRCA2 in women who were diagnosed with DCIS. METHODS: One hundred eighteen women with DCIS who were referred for genetic counseling and underwent genetic testing for BRCA1/BRCA2 mutations between 2003 and 2010 were included in the study. Logistic regression models were fit to determine the associations between potential predictive factors and BRCA status. RESULTS: Of 118 high-risk women with DCIS, 27% (n = 32) tested positive for BRCA1/BRCA2 mutations. Of those, 10% (n = 12) and 17% (n = 20) had BRCA1 and BRCA2 mutations, respectively. Age, race, and tumor characteristics did not differ between BRCA noncarriers and carriers. In a multivariate logistic model, ≥2 relatives with ovarian cancer (OC) (odds ratio [OR], 8.81; 95% confidence interval [CI], 1.38-56.29; P =.034), and a score ≥10% according to the BRCAPRO mathematical model for calculating the probability that a particular family member carries a germline BRCA mutation (OR, 6.37; 95% CI, 2.23-18.22; P =.0005) remained as independent significant predictors for a BRCA mutation. Fifty-seven percent of mutation carriers but only 25% of noncarriers underwent prophylactic mastectomy(P =.0037). This difference remained significant for patients aged ≤40 years (P =.025). CONCLUSIONS: Women who had DCIS and a family history of OC or who had BRCAPRO scores a;circyen&10% had a high rate of BRCA positivity regardless of age at diagnosis. These findings suggest that high-risk patients with DCIS are appropriate candidates for genetic testing for BRCA mutations in the presence of predictive factors even if they do not have invasive breast cancer.
AB - BACKGROUND: It is unclear whether women with ductal carcinoma in situ (DCIS), like their counterparts with invasive breast cancer, warrant genetic risk assessment and testing on the basis of high-risk variables. The authors of this report identified predictive factors for mutations in the breast cancer-susceptibility genes BRCA1 and BRCA2 in women who were diagnosed with DCIS. METHODS: One hundred eighteen women with DCIS who were referred for genetic counseling and underwent genetic testing for BRCA1/BRCA2 mutations between 2003 and 2010 were included in the study. Logistic regression models were fit to determine the associations between potential predictive factors and BRCA status. RESULTS: Of 118 high-risk women with DCIS, 27% (n = 32) tested positive for BRCA1/BRCA2 mutations. Of those, 10% (n = 12) and 17% (n = 20) had BRCA1 and BRCA2 mutations, respectively. Age, race, and tumor characteristics did not differ between BRCA noncarriers and carriers. In a multivariate logistic model, ≥2 relatives with ovarian cancer (OC) (odds ratio [OR], 8.81; 95% confidence interval [CI], 1.38-56.29; P =.034), and a score ≥10% according to the BRCAPRO mathematical model for calculating the probability that a particular family member carries a germline BRCA mutation (OR, 6.37; 95% CI, 2.23-18.22; P =.0005) remained as independent significant predictors for a BRCA mutation. Fifty-seven percent of mutation carriers but only 25% of noncarriers underwent prophylactic mastectomy(P =.0037). This difference remained significant for patients aged ≤40 years (P =.025). CONCLUSIONS: Women who had DCIS and a family history of OC or who had BRCAPRO scores a;circyen&10% had a high rate of BRCA positivity regardless of age at diagnosis. These findings suggest that high-risk patients with DCIS are appropriate candidates for genetic testing for BRCA mutations in the presence of predictive factors even if they do not have invasive breast cancer.
KW - BRCA 1/2 mutations
KW - BRCAPRO
KW - ductal carcinoma in situ
KW - family history
KW - predictive factors
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U2 - 10.1002/cncr.26428
DO - 10.1002/cncr.26428
M3 - Article
C2 - 22009639
AN - SCOPUS:84857999736
SN - 0008-543X
VL - 118
SP - 1515
EP - 1522
JO - Cancer
JF - Cancer
IS - 6
ER -