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International variation in rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers

International variation in rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers,10.1002/ijc.23340,International Journal of Cance

International variation in rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers   (Citations: 32)
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Kelly A. Metcalfe, Daphna Birenbaum-Carmeli, Jan Lubinski, Jacek Gronwald, Henry Lynch, Pal Moller, Parviz Ghadirian, William D. Foulkes, J. G. M. Klijn, Eitan Friedman, Charmaine Kim-Sing, Peter Ainsworthhttp://academic.research.microsoft.com/io.ashx?type=5&id=33819252&selfId1=0&selfId2=0&maxNumber=12&query=
Several options for cancer prevention are available for women with a BRCA1 or BRCA2 mutation, including prophylactic surgery, chemoprevention and screening. The authors report on preventive practices in women with mutations from 9 countries and examine differences in uptake according to country. Women with a BRCA1 or BRCA2 mutation were contacted after receiving their genetic test result and were questioned regarding their preventive practices. Information was recorded on prophylactic mastectomy, prophylactic oophorectomy, use of tamoxifen and screening (MRI and mammography). Two thousand six hundred seventy-seven women with a BRCA1 or BRCA2 mutation from 9 countries were included. The follow-up questionnaire was completed a mean of 3.9 years (range 1.5-10.3 years) after genetic testing. One thousand five hundred thirty-one women (57.2%) had a bilateral prophylactic oophorectomy. Of the 1,383 women without breast cancer, 248 (18.0%) had had a prophylactic bilateral mastectomy. Among those who did not have a prophylactic mastectomy, only 76 women (5.5%) took tamoxifen and 40 women (2.9%) took raloxifene for breast cancer prevention. Approximately one-half of the women at risk for breast cancer had taken no preventive option, relying solely on screening. There were large differences in the uptake of the different preventive options by country of residence. Prophylactic oophorectomy is now generally accepted by women and their physicians as a cancer preventive measure. However, only the minority of women with a BRCA1 or BRCA2 mutation opt for prophylactic mastectomy or take tamoxifen for the prevention of hereditary breast cancer. Approximately one-half of women at risk for breast cancer rely on screening alone.
Journal: International Journal of Cancer - INT J CANCER , vol. 122, no. 9, pp. 2017-2022, 2008
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    • ...However, in the Netherlands HRT has not been widely used by postmenopausal carriers (see Table 1 and [49])...

    Peggy Manderset al. Body weight and risk of breast cancer in BRCA1/2 mutation carriers

    • ...Currently, mutation carriers who have not been diagnosed with cancer may choose among or combine several preventive strategies: primary prevention with chemopreventive agents (e.g., tamoxifen), prophylactic mastectomy or prophylactic BSO; and secondary prevention with mammography and MRI [2, 16]...
    • ...These findings are similar to those reported in a recent study of an international group of 2,677 BRCA mutation carriers [16]...

    Victor R. Grannet al. Comparative effectiveness of screening and prevention strategies among...

    • ...For ovarian cancer it was recently shown that current screening protocols are ineffective in detecting early stage ovarian cancer in mutation carriers [13, 14] and the only effective strategy to prevent ovarian cancer death is a risk reducing salpingooophorectomy (RRSO), which is eventually chosen by approximately 70% of these women [15, 16]...

    Ingrid E. Fakkertet al. Breast cancer screening in BRCA1 and BRCA2 mutation carriers after ris...

    • ...Uptake of tamoxifen for chemoprevention among BRCA mutation carriers, however, is low, with only 5.5% of unaffected BRCA mutation carriers reporting tamoxifen use a mean of 3.7 years after genetic testing in an international cross-sectional study [30]...

    Karen Lisa Smithet al. Poly(ADP-Ribose) Inhibition: Exploring a New Approach to Breast Cancer...

    • ...There also have been reports on the variation of choice of management for women who are found to carry the BRCA1 or BRCA2 mutation between European countries and the United States [32] due to the different perception of risk, availability of such measures, and cost [32]...
    • ...There also have been reports on the variation of choice of management for women who are found to carry the BRCA1 or BRCA2 mutation between European countries and the United States [32] due to the different perception of risk, availability of such measures, and cost [32]...
    • ...One study, which included a number of countries, such as the United States, Canada, and various European countries, found that the uptake rate of prophylactic mastectomy ranges from 4.2– 4.5% in Israel and Norway to 36.3% in the United States; uptake rates of prophylactic oophorectomy is usually higher, ranging from 34.9% in Poland to 71% in France and the United States [32, 44]...
    • ...There also was a variation in the uptake of type of breast screening between countries where mammography is generally an accepted form of screening (65.5 to 100%) but uptake of MRI breast screening ranged from 2.2% in Israel to 94.6% in Holland [32]...
    • ...Prophylactic mastectomy rate (including completion mastectomy and contralateral prophylactic mastectomy) was 21.1% overall in all mutation carriers, which is in the mid range compared with that of international studies [32]...
    • ...The uptake rate of prophylactic salpingo-oophorectomy was 32%, which is slightly higher than that of prophylactic mastectomy but relatively low compared with most western countries, especially the United States [32]...

    Ava Kwonget al. Choice of Management of Southern Chinese BRCA Mutation Carriers

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