Different Patterns of Risk Reducing Decisions in Affected or Unaffected BRCA Pathogenic Variant Carriers
| Autor: | Eun Gyeong Lee, Myong Cheol Lim, Sun-Young Kong, Boram Park, Sang Yoon Park, Jai Hong Han, So Youn Jung, Soo Jin Park, Hyok Jo Kang, Han Sung Kang, Seeyoun Lee, Eun Sook Lee, Jungnam Joo, Boyoung Park |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Clinical Decision-Making Salpingo-oophorectomy Breast Neoplasms Brca testing Breast Neoplasms Male Breast cancer Internal medicine Severity of illness Republic of Korea medicine Humans Genetic Predisposition to Disease Genetic Testing Family history Watchful Waiting Prophylactic surgical procedure Retrospective Studies BRCA2 Protein Ovarian Neoplasms business.industry BRCA1 Protein Patient choice Cancer Middle Aged medicine.disease BRCA1 BRCA2 Oncology National health insurance Mutation Original Article Female Ovarian cancer business Familial breast cancer |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| Popis: | PURPOSE The purpose of this study was to investigate decision patterns to reduce the risks of BRCArelated breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and riskreducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers. Materials and Methods The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management. RESULTS Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC,which significantly differed between BRCA1 and BRCA2 carriers (p < 0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 of the 83 carriers (71.1%) with BC and the 39 of 79 unaffected carriers (49.4%) underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of RR surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p < 0.001). CONCLUSION RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness. |
| Databáze: | OpenAIRE |
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