High risk surveillance MRI may not be necessary in BRCA1/2 mutation carriers over 70 years old
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View abstract on PubMed
Summary
This summary is machine-generated.For women aged 70 and older with BRCA1/2 mutations, mammograms may be sufficient for breast cancer surveillance. This suggests individualized care and potentially less intensive screening for older carriers.
Area Of Science
- Oncology
- Genetics
- Radiology
Background
- Women with BRCA1/2 mutations have a high lifetime risk of breast cancer (69-72% up to age 80).
- Risk estimates for breast cancer become less reliable in later life.
- Many older BRCA1/2 carriers without breast cancer undergo intensive surveillance.
Purpose Of The Study
- To evaluate breast cancer diagnoses in women aged 70 and older with BRCA1/2 mutations.
- To identify the imaging modality responsible for diagnosing malignancy in this age group.
Main Methods
- Retrospective review of females with BRCA1/2 mutations diagnosed between 1996 and 2022.
- Cohort stratified by age at BRCA1/2 diagnosis: 30-59, 60-69, and ≥70 years.
- Recorded number of malignancies and the imaging modality used for diagnosis.
Main Results
- Of 316 patients, 15 (4.7%) were aged ≥70 at genetic testing.
- Breast malignancies were diagnosed in 40% of patients aged ≥70, compared to 60.5% (30-59) and 31.4% (60-69).
- In patients aged ≥70 with breast cancer, 66.7% were detected by mammogram.
Conclusions
- Mammography may be adequate for breast cancer surveillance in women aged ≥70 with BRCA1/2 mutations.
- Individualized care and de-escalated surveillance should be considered for older BRCA1/2 carriers.
- This approach acknowledges that some older carriers may not develop breast cancer.
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