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对BRCA致病变体携带者与乳腺癌进行乳腺保护的临床结果

Kerollos Nashat Wanis¹, Henry M Kuerer¹, Susie X Sun¹

¹Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, Texas.

JAMA network open

|June 25, 2024

概括

接受乳腺保护治疗的BRCA相关乳腺癌妇女患乳腺癌的风险增加,但大多数女性没有额外的癌症和双边乳房切除术. 这些发现支持BRCA携带者乳腺保护的共同决策.

科学领域:

在瘤学瘤学.
遗传学是一个遗传学.
手术瘤学手术瘤学

背景情况:

目前的指导方针支持BRCA相关乳腺癌的乳腺保护疗法 (BCT),但大多数患者选择乳腺切除术.
了解BCT结果对于扩大基因测试和向疗法至关重要.

研究的目的:

用BCT治疗的BRCA相关乳腺癌妇女的临床结果的评估.
评估两侧和两侧乳腺癌事件的风险和双边乳腺切除术无生存率.

主要方法:

这是一项单一机构对172名患有病原性BRCA1/2变异的妇女进行的队列研究,这些妇女在1977-2021年期间接受BCT治疗.
分析包括对BRCA1/2携带者进行比较,并计算生存和癌症事件风险.

主要成果:

随访时间平均为11.8年,10年总生存率为88.5%.
双边乳房切除术的10年无存活率为70.7%,双边乳腺癌风险为12.2%,双边乳腺癌风险为21.3%.
与BRCA1携带者相比,BRCA1携带者的风险包括较年轻的诊断年龄,更先进的,荷尔蒙受体阴性,较高等级的瘤与BRCA2携带者相比.

结论:

接受BCT的BRCA变异女性面临较高的ipsilateral和contralateral乳腺癌风险.
然而,大多数人仍然没有额外的癌症事件和双边乳房切除术.
调查结果为考虑乳腺保护的BRCA载体提供了知情决策的帮助.

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