Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline
| Autor: | Jill R. Dietz, Ismail Jatoi, Elaine Kennedy, Nadine Tung, Nina A. Mayr, Dana Zakalik, E Hofstatter, Mark R. Somerfield, Judy C. Boughey, Claudine Isaacs, Mark G. Trombetta, Rubina Qamar, Isabelle Bedrosian, Jennifer K. Litton, Anthony E. Dragun, Brittany E. Harvey, Judith Balmana Gelpi, Lori J. Pierce, Mark E. Robson |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Genes BRCA2 Genes BRCA1 Breast Neoplasms Medical Oncology 03 medical and health sciences 0302 clinical medicine Breast cancer Surgical oncology Radiation oncology medicine Humans Societies Medical Clinical Oncology business.industry Guideline medicine.disease Surgical Oncology 030104 developmental biology Oncology 030220 oncology & carcinogenesis Family medicine Mutation Practice Guidelines as Topic Radiation Oncology Female business Hereditary Breast Cancer |
| Zdroj: | Journal of Clinical Oncology. 38:2080-2106 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.20.00299 |
| Popis: | PURPOSE To develop recommendations for management of patients with breast cancer (BC) with germline mutations in BC susceptibility genes. METHODS The American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology convened an Expert Panel to develop recommendations based on a systematic review of the literature and a formal consensus process. RESULTS Fifty-eight articles met eligibility criteria and formed the evidentiary basis for the local therapy recommendations; six randomized controlled trials of systemic therapy met eligibility criteria. RECOMMENDATIONS Patients with newly diagnosed BC and BRCA1/ 2 mutations may be considered for breast-conserving therapy (BCT), with local control of the index cancer similar to that of noncarriers. The significant risk of a contralateral BC (CBC), especially in young women, and the higher risk of new cancers in the ipsilateral breast warrant discussion of bilateral mastectomy. Patients with mutations in moderate-risk genes should be offered BCT. For women with mutations in BRCA1/ 2 or moderate-penetrance genes who are eligible for mastectomy, nipple-sparing mastectomy is a reasonable approach. There is no evidence of increased toxicity or CBC events from radiation exposure in BRCA1/ 2 carriers. Radiation therapy should not be withheld in ATM carriers. For patients with germline TP53 mutations, mastectomy is advised; radiation therapy is contraindicated except in those with significant risk of locoregional recurrence. Platinum agents are recommended versus taxanes to treat advanced BC in BRCA carriers. In the adjuvant/neoadjuvant setting, data do not support the routine addition of platinum to anthracycline- and taxane-based chemotherapy. Poly (ADP-ribose) polymerase (PARP) inhibitors (olaparib and talazoparib) are preferable to nonplatinum single-agent chemotherapy for treatment of advanced BC in BRCA1/ 2 carriers. Data are insufficient to recommend PARP inhibitor use in the early setting or in moderate-penetrance carriers. Additional information available at www.asco.org/breast-cancer-guidelines . |
| Databáze: | OpenAIRE |
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