The impact of a false-positive MRI on the choice for mastectomy in BRCA mutation carriers is limited

Hoogerbrugge, Nicoline; Kamm, Y.J.L.; Bult, Peter; Landsbergen, K. M.; Bongers, Ernie M.H.F.; Brunner, Han G.; Bonenkamp, Han J.; Hullu, Joanne A. de; Ligtenberg, M. J. L.; Boetes, C.

doi:10.1093/annonc/mdm537

Cited by 39 publications

(21 citation statements)

References 24 publications

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“…Van djik et al [27] found that before testing for genetic BRCA mutations, 25 of 77 women carrying the mutation intended to perform PM and, after a period of 9 months, 19 women had undergone the intervention. Hoogerburg et al [28] found that among the women who intended to undergo PM before genetic results, between 66% and 89% (the variation is dependent on the coexistence of false positive results in MRI surveillance) performed PM at an average period of 2 years post-testing, while only 11% to 15% of women who initially had intentions to adopt the strategy of surveillance for risk reduction, conducted PM. In a study by Kurian et al [29], the majority of patients (85% (CI 68.9% -95.1%)) maintained their attitude against adopting PM interventions or were even more decided not to undergo this intervention, one year after the genetic tests.…”

Section: Choosing Prophylactic Mastectomy (Pm)mentioning

confidence: 99%

“…The average age of women who undergo mastectomy interventions was quite variable in the analysed studies; the age range was between 37 and 46 years of age, the majority had children and were married [18][19][20][21][22][23][24][25][26][27][28][29][30]. Women with a history of prior breast cancer are more likely to do prophylactic surgery instead of surveillance (p = 0.003) [20].…”

Section: Choosing Prophylactic Mastectomy (Pm)mentioning

confidence: 99%

“…These authors found that younger age and preference for PM prior to genetic testing are the stronger predictors of PM (R2 = 0.57). In what concerns prior preference for PM, other authors [27][28][29] also refer to the stability strong determination of women's decisions regarding strategies to reduce risk of breast and ovarian cancer, but more specifically regarding prophylactic surgery. This issue is seen as the most predictive variable of the process of decision-making.…”

Section: Decision-making Factorsmentioning

confidence: 99%

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Reasons for Prophylactic Mastectomy in Women Carrying BRCA 1/2 Mutation: A Systematic Literature Review

Machado¹

2013

ABCR

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Although the majority of breast cancers are sporadic, it is estimated that between 5% and 10% of cases are hereditary and mostly associated with BRCA 1 and BRCA 2 mutations. Women with BRCA 1 or BRCA 2 mutation present up to 95% increased risk of breast cancer and are advised to take preventive measures. Surveillance, chemoprevention and prophylactic surgery (mastectomy and oophorectomy) are risk-reducing strategies. This literature review aims to respond to two major questions: 1) to what extent is the decision-making for prophylactic mastectomy in women with the BRCA mutation a more relevant option than other strategies, and 2) what are the major factors influencing the decision for mastectomy? For this purpose, 27 published articles were reviewed. Results show: a) the decision for mastectomy is more frequent in women carrying BRCA 1/2 mutation than in non-carriers; mastectomy being less frequent than oophorectomy; b) the decision-making is significantly associated with BRCA mutation, parity, age and family history; c) reasons underlying women decision-making relate to anxiety toward the risk of cancer, concerns with surgery, body-image and sexuality. It is discussed that, due to the complexity of the decision-making process, these cases require a careful and meticulous approach regarding information provided, and in addressing concerns.

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Section: Choosing Prophylactic Mastectomy (Pm)mentioning

confidence: 99%

Section: Choosing Prophylactic Mastectomy (Pm)mentioning

confidence: 99%

Section: Decision-making Factorsmentioning

confidence: 99%

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Reasons for Prophylactic Mastectomy in Women Carrying BRCA 1/2 Mutation: A Systematic Literature Review

Machado¹

2013

ABCR

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“…A major problem with breast MRI is the high incidence of a false positive test result. 8 It is emphasised again that these diagnostic strategies will not impact on the incidence of the disease or the chance of getting breast cancer, but aims to improve survival by downstaging. The impact of any or all of these measures on survival is diffi cult to estimate or model.…”

Section: Early Diagnosismentioning

confidence: 99%

Familial and genetic cancers in gynaecology

Dreyer

2010

Southern African Journal of Gynaecological Oncology

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The diagnosis of inherited cancer-susceptibility syndromes can enable identifi cation of individuals at increased risk for earlyonset cancer. The treatment and prognosis of patients diagnosed with malignancy due to a germ-line mutation may differ from the standard therapy.Hereditary breast and ovarian cancer (HBOC) syndrome and hereditary non-polyposis colon cancer (HNPCC) syndrome are the two most important syndromes responsible for inherited cancers in gynaecology. Genetic testing is available for both these syndromes. BRCA testing is affordable and easy in South Africa for patients with Afrikaner or Ashkenazi ancestry, as the mutation patterns are known.Women's health care clinicians must be well informed about these cancer syndromes. Families with a potential genetic mutation should be identifi ed and referred for investigation or counselled for genetic testing. Counselling pre-requisites include complete information about the disease, genetic tests, estimated cancer risk and cancer risk management.Individualised cancer risk can be estimated based on genetic and/or clinical information. Breast, endometrial and ovarian cancers are potentially either preventable or qualify for early detection through advanced screening techniques. Surgical and hormonal prevention is effective, but has important economic, psychosocial and clinical implications. Early detection techniques offer less protection and a smaller improvement in morbidity and mortality. Screening is also a costly option but may be more acceptable to some patients.In colon cancer syndromes, the risk for endometrial and ovarian cancer is much elevated. These risks should be recognised and addressed, as these diseases are easy to prevent.

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“…MRI is a highly sensitive imaging technique, but lacks information on specificity, and thus it has high rate of false positive results [7]. The impact of misdiagnosis on the patient is considerable, particularly when they are confronted with unnecessary surgeries.…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer Diagnosis Using Microwave and Hybrid Imaging Methods

Abbosh¹

2014

IJCSES

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The impact of a false-positive MRI on the choice for mastectomy in BRCA mutation carriers is limited

Abstract: Although the rate of false-positive MRI results is high, the impact on the choice for prophylactic mastectomy is limited and is determined by the woman's preference before the establishment of a BRCA mutation.

Cited by 39 publications

References 24 publications

Reasons for Prophylactic Mastectomy in Women Carrying BRCA 1/2 Mutation: A Systematic Literature Review

Reasons for Prophylactic Mastectomy in Women Carrying BRCA 1/2 Mutation: A Systematic Literature Review

Familial and genetic cancers in gynaecology

Breast Cancer Diagnosis Using Microwave and Hybrid Imaging Methods

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