The challenging screen detection of ovarian cancer in BRCA mutation carriers adhering to a 6-month follow-up program

9569 Background: Ten to 15% of ovarian cancer patients are BRCA mutation carriers. By offering genetic testing, families at risk and healthy female mutation carriers will be identified and offered clinical follow-up. The MICRA questionnaire was developed as a brief, practical, and targeted assessment of concerns and psychosocial issues associated with genetic testing. This study evaluates the practical and psychometric properties of the MICRA (Norwegian translation) in tested ovarian cancer patient. Methods: Since 2002, ovarian cancer patients at Oslo University Hospital, Norwegian Radium Hospital are offered genetic counseling and testing. By the end of 2009, 1,032 were included. The 530 (51%) patients still alive, were mailed the MICRA and three other instruments relevant for mental distress. 354 (67%) patients responded. Among them 9% were BRCA mutation carriers, 7% had a personal history of breast cancer, 29% had a family history of breast and/or ovarian cancer, and 55% had no such family history. Results: In the BRCA mutation carrier group, the total MICRA score and its subscale scores of distress, uncertainty, and positive experiences were all significantly higher than in the other groups. Confirmatory factor analyses of the three subscales of MICRA showed inadequate fit indices, while a four factors solution including the new factor of Support from family (items #18 and #19), showed adequate fit. The Positive Experiences subscale showed a maximum of 4% explained variance in relation to the Hospital Anxiety and Depression Scale total score, the Impact of Event Avoidance and Intrusion scores, and the Eysenck’s Neuroticism score. The subscales of Distress and Uncertainty showed maximum 12% and 41% explained variance, respectively, while the total MICRA score showed 22% explained variance. Conclusions: Our study supports the feasibility of the MICRA in ovarian cancer patients. Frail women may be identified for closer follow-up by using MICRA. Discrimant, content and construct validities of the MICRA were supported, while the factor structure still is open to further investigation.

Download Full-text

Recommendations and Choices for BRCA Mutation Carriers at Risk for Ovarian Cancer: A Complicated Decision

Cancers ◽

10.3390/cancers10020057 ◽

2018 ◽

Vol 10 (2) ◽

pp. 57 ◽

Cited By ~ 13

Author(s):

Kelsey Lewis ◽

Karen Lu ◽

Amber Klimczak ◽

Samuel Mok

Keyword(s):

Ovarian Cancer ◽

At Risk ◽

Brca Mutation ◽

Mutation Carriers ◽

Brca Mutation Carriers

Download Full-text

Cost Effectiveness of Risk-Reducing Mastectomy versus Surveillance in BRCA Mutation Carriers with a History of Ovarian Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-017-5995-z ◽

2017 ◽

Vol 24 (11) ◽

pp. 3116-3123 ◽

Cited By ~ 5

Author(s):

Charlotte Gamble ◽

Laura J. Havrilesky ◽

Evan R. Myers ◽

Junzo P. Chino ◽

Scott Hollenbeck ◽

...

Keyword(s):

Ovarian Cancer ◽

Cost Effectiveness ◽

Brca Mutation ◽

Mutation Carriers ◽

Brca Mutation Carriers ◽

History Of ◽

Risk Reducing

Download Full-text

Factors Impacting on Decision-Making towards Prophylactic Surgeries in BRCA Mutation Carriers and Women with Familial Predisposition

Breast Care ◽

10.1159/000503370 ◽

2019 ◽

Vol 15 (3) ◽

pp. 253-259

Author(s):

Robin Segerer ◽

Clara Peschel ◽

Ulrike Kämmerer ◽

Sebastian Häussler ◽

Achim Wöckel ◽

...

Keyword(s):

Ovarian Cancer ◽

Decision Making ◽

Brca Mutation ◽

Prophylactic Surgery ◽

Sexual Life ◽

Familial Predisposition ◽

Emotional Factors ◽

Mutation Carriers ◽

Brca Mutation Carriers ◽

Psychological Predictor

Background/Objectives: BRCA mutation carriers and women at high risk of breast/ovarian cancer are faced with the intricate question to opt for prophylactic surgeries and/or a periodic screening. The aim of this study was therefore to identify objective and emotional factors that have an impact on the decision-making process. Methods: Ninety-five women with BRCA mutations or women at increased breast/ovarian cancer lifetime risk were counseled at our outpatient department and either opted for prophylactic surgery or periodic screening. To identify the psychological factors that could have influenced the decision-making, a standardized questionnaire was applied. Additionally, clinical data were collected and were reviewed by a personal talk. Results: Seventy-one of the patients opted for an increased surveillance only, 21 for prophylactic surgeries. Positive predictors for prophylactic surgeries were sociodemographic characteristics such as parity and objective variables such as verified mutation status. Hierarchical regression analysis revealed that the need for safety in health issues has been the only significant psychological predictor of surgery beyond the objective factors. Fear of surgical procedures, menopausal symptoms after surgery, loss of attractiveness, or fear of interferences with sexual life did not significantly affect decision-making. Conclusion: Decision-making towards prophylactic surgeries is influenced by objective but also emotional factors. Knowing that fear and anxiety also have an important impact on decision-making, distinct counselling about the procedures, the subsequent risk reduction as well as the psychological effects of prophylactic surgeries are essential.

Download Full-text

Breast Cancer Following Ovarian Cancer in BRCA Mutation Carriers

Gynecologic Oncology ◽

10.1016/j.ygyno.2019.11.064 ◽

2020 ◽

Vol 156 (3) ◽

pp. e14-e15

Author(s):

A.I. Nañez ◽

S. Langer ◽

C. Garcia ◽

C.B. Powell

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Brca Mutation ◽

Mutation Carriers ◽

Brca Mutation Carriers

Download Full-text

Comparison of risk-reducing surgery in women with BRCA and non-BRCA ovarian cancer susceptibility genes.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.1547 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 1547-1547

Author(s):

Zachary Phillip Schwartz ◽

Mae Zakhour ◽

Andrew John Li ◽

Christine S. Walsh ◽

Bj Rimel ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Susceptibility ◽

Brca Mutation ◽

Susceptibility Genes ◽

Brca Mutations ◽

Cancer Susceptibility Genes ◽

Mutation Carriers ◽

Brca Mutation Carriers ◽

History Of ◽

Risk Reducing

1547 Background: Risk reducing gynecologic surgery (RRSO) is standard of care for women with BRCA mutations. The optimal management for women with non-BRCA ovarian cancer susceptibility mutations remains unclear. We sought to characterize the practice patterns for these women at our two institutions. Methods: Women with germline ovarian cancer susceptibility genes who had a RRSO were identified from 1/2000-1/2019 in an IRB approved study. All patients were asymptomatic with no suspicion for malignancy at time of RRSO. Clinico-pathologic characteristics were extracted from the medical records. Continuous variables were analyzed with Kruskal-Wallis and categorical variables analyzed with chi square and t-tests. Results: 152 BRCA1, 95 BRCA2, and 63 Non-BRCA mutation carriers were identified—50 Lynch (22 MLH1, 13 MSH2, 13 MSH6, 2 PMS2) and 13 Other (6 BRIP1, 2 RAD51C, 5 RAD51D). There was no difference between age at testing, age at RRSO, and interval between testing and RRSO between groups. Genetic counseling was higher in Non-BRCA patients. Family history of ovarian cancer was more common in women with BRCA1 and Other germline mutations compared to BRCA2 and Lynch. Family and personal history of breast cancer was high in all groups except Lynch carriers. Prophylactic mastectomy was seen mostly in BRCA mutation carriers. Concomitant hysterectomy was performed in the majority of women (BRCA1 59%, BRCA2 57%, and Other 62%), with the highest frequency in Lynch carriers (86%, p<.01). Occult cancer was only seen in BRCA mutation carriers: BRCA1 (7%), BRCA2 (2%), Lynch (0%), Other (0%). Conclusions: In this cohort, women with Non-BRCA mutations are managed similarly to women with BRCA mutations. We observed no occult cancers in Non-BRCA patients. The optimal role of surgery as a risk reducing strategy in this group requires further study. [Table: see text]

Download Full-text

Breast cancer incidence in BRCA mutation carriers with ovarian cancer: A longitudal observational study

Gynecologic Oncology ◽

10.1016/j.ygyno.2021.06.009 ◽

2021 ◽

Author(s):

Tamar Safra ◽

Barliz Waissengrin ◽

Deanna Gerber ◽

Rinat Bernstein-Molho ◽

Geula Klorin ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Observational Study ◽

Cancer Incidence ◽

Brca Mutation ◽

Breast Cancer Incidence ◽

Mutation Carriers ◽

Brca Mutation Carriers

Download Full-text

Population attributes affecting the prevalence of BRCA mutation carriers in epithelial ovarian cancer cases in israel

Gynecologic Oncology ◽

10.1016/s0090-8258(03)00152-5 ◽

2003 ◽

Vol 89 (3) ◽

pp. 494-498 ◽

Cited By ~ 49

Author(s):

G Hirsh-Yechezkel ◽

A Chetrit ◽

F Lubin ◽

E Friedman ◽

T Peretz ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Brca Mutation ◽

Mutation Carriers ◽

Brca Mutation Carriers

Download Full-text

Aromatase Inhibitors and Contralateral Breast Cancer in BRCA Mutation Carriers: A long-term Follow-up

10.21203/rs.3.rs-1158051/v1 ◽

2021 ◽

Author(s):

Maryam Nemati Shafaee ◽

Kristina Goutsouliak ◽

Heather Lin ◽

Therese B Bevers ◽

Angelica Gutierrez-Barrera ◽

...

Keyword(s):

Breast Cancer ◽

Aromatase Inhibitors ◽

Prophylactic Mastectomy ◽

Brca Mutation ◽

Brca1 Mutation ◽

Brca2 Mutation ◽

Mutation Status ◽

Mutation Carriers ◽

Brca Mutation Carriers

Abstract Background: Deleterious BRCA mutations confer a significant lifetime risk of breast cancer (BC) as well as contralateral BC (CBC) in patients who do not undergo prophylactic mastectomy. Prior reports have suggested that tamoxifen reduces the risk of CBC in BRCA mutation carriers. Whether aromatase inhibitors (AI) have the same effect is unknown. Methods: This is a retrospective review of patients diagnosed with non-metastatic ER+ BC between 2004-2014 with known BRCA mutation status. Patients were followed from primary diagnosis until CBC diagnosis or death. Median follow up was 11.5 years. Risk of CBC was evaluated as time to event. Results: 935 subjects were included in this analysis, with 53 BRCA1 mutation carriers, and 94 BRCA2 mutation carriers. Median age at diagnosis was 42.7 years. Seventy-two percent (676) received tamoxifen and 43% (405) received AI. A total of 66 CBCs occurred, of which 10% (15/147) occurred in BRCA mutation carriers vs %6.5 (51/788) in BRCA wild type. Multivariate analyses indicated that BRCA status and AI use were significantly associated with CBC risk. AI use resulted in a significant reduction in risk of CBC (HR 0.44, p=0.004) regardless of the BRCA mutation status. Tamoxifen use was not associated with reduced risk of CBC. Conclusions: This is the first report showing that AIs reduce the risk of CBC in BRCA mutation carriers. The potential role of AIs as chemoprevention should be validated in larger independent cohorts.

Download Full-text