Endometrial Cancer Risk Among Germline BRCA1 / 2 Pathogenic Variant Carriers: Review of Our Current Understanding and Next Steps.

Autor:	Sorouri K; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA., Lynce F; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA., Feltmate CM; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA., Davis MR; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA., Muto MG; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA., Konstantinopoulos PA; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, MA., Stover EH; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, MA., Kurian AW; Stanford University School of Medicine, Stanford, CA., Hill SJ; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA., Partridge AH; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA., Tolaney SM; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA., Garber JE; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA.; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA., Bychkovsky BL; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.; Harvard Medical School, Boston, MA.; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA.; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA.
Jazyk:	angličtina
Zdroj:	JCO precision oncology [JCO Precis Oncol] 2023 Sep; Vol. 7, pp. e2300290.
DOI:	10.1200/PO.23.00290
Abstrakt:	Purpose: To review the literature exploring endometrial cancer (EC) risk among surgical candidates with germline BRCA1/2 pathogenic variants (PVs) to guide decisions around risk-reducing (rr) hysterectomy in this population. Design: A comprehensive review was conducted of the current literature that influences clinical practice and informs expert consensus. We present our understanding of EC risk among BRCA1/2 PV carriers, the risk-modifying factors specific to this patient population, and the available research technology that may guide clinical practice in the future. Limitations of the existing literature are outlined. Results: Patients with BRCA1/2 PVs, those with a personal history of tamoxifen use, those who desire long-term hormone replacement therapy, and/or have an elevated BMI are at higher risk of EC, primarily endometrioid EC and/or uterine papillary serous carcinoma, and may benefit from rr-hysterectomy. Although prescriptive clinical guidelines specific to BRCA1/2 PV carriers could inform decisions around rr-hysterectomy, limitations of the current literature prevent more definitive guidance at this time. A large population-based study of a contemporary cohort of BRCA1/2 PV carriers with lifetime follow-up compared with cancer-gene negative controls would advance this topic and facilitate care decisions. Conclusion: This review validates a potential role for rr-hysterectomy to address EC risk among surgical candidates with BRCA1/2 PVs. Evidence-based clinical guidelines for rr-hysterectomy in BRCA1/2 PV carriers are essential to ensure equitable access to this preventive measure, supporting insurance coverage for patients with either BRCA1 or BRCA2 PVs to pursue rr-hysterectomy. Overall, this review highlights the complexity of EC risk in BRCA1/2 PV carriers and offers a comprehensive framework to shared decision making to inform rr-hysterectomy for BRCA1/2 PV carriers.
Databáze:	MEDLINE
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