EUS-based Pancreatic Cancer Surveillance in BRCA1/BRCA2/PALB2/ATM Carriers Without a Family History of Pancreatic Cancer
Autor: | Christina M. Dudzik, Jessica Ebrahimzadeh, Anil K. Rustgi, Dana Farengo Clark, Michael L. Kochman, Nuzhat A. Ahmad, Bryson W. Katona, Payal D. Shah, Jacquelyn Powers, Jessica M. Long, Kirk J. Wangensteen, Sara Attalla, Erica L. Carpenter, Jordan Heiman, Koushik K. Das, Gregory G. Ginsberg, Susan M. Domchek, Kara N. Maxwell, Angela R. Bradbury, Danielle McKenna, Gillain Constantino |
---|---|
Rok vydání: | 2021 |
Předmět: |
Oncology
Endoscopic ultrasound Heterozygote Cancer Research medicine.medical_specialty endocrine system diseases PALB2 Population Ataxia Telangiectasia Mutated Proteins Article Interquartile range Pancreatic cancer Internal medicine Pancreatic mass Humans Medicine Genetic Predisposition to Disease Family history skin and connective tissue diseases education Germ-Line Mutation Retrospective Studies BRCA2 Protein education.field_of_study medicine.diagnostic_test BRCA1 Protein business.industry Cancer Middle Aged medicine.disease digestive system diseases Pancreatic Neoplasms Female Fanconi Anemia Complementation Group N Protein business Carcinoma Pancreatic Ductal |
Zdroj: | Cancer Prev Res (Phila) |
ISSN: | 1940-6215 1940-6207 |
Popis: | Carriers of a pathogenic/likely pathogenic (P/LP) BRCA1/BRCA2/ATM/PALB2 variant are at increased risk of pancreatic ductal adenocarcinoma (PDAC), yet current guidelines recommend surveillance only for those with a family history of PDAC. We aimed to investigate outcomes of endoscopic ultrasound (EUS)–based PDAC surveillance in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC. We performed a retrospective analysis of all P/LP BRCA1/BRCA2/ATM/PALB2 carriers who underwent EUS at a tertiary care center. Of 194 P/LP BRCA1/BRCA2/ATM/PALB2 carriers who underwent EUS, 64 (33%) had no family history of PDAC and had at least 1 EUS for PDAC surveillance. These individuals underwent 143 total EUSs, were predominantly female (72%), and BRCA2 carriers (73%), with the majority having a personal history of cancer other than PDAC (67%). The median age at time of first EUS was 62 years [interquartile range (IQR), 53–67 years] and a median of 2 EUSs (IQR 1–3) were performed per patient, with a median of 3 years (IQR 2–4.5 years) between the first and last EUS for those with more than 1 EUS. Pancreatic abnormalities were detected in 44%, including cysts in 27%, and incidental luminal abnormalities in 41%. Eight percent developed a new pancreatic mass or cyst during surveillance, 2 individuals developed PDAC, and no serious complications resulted from surveillance. After discussion of the risks, limitations, and potential benefits, PDAC surveillance can be considered in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC; however, the effectiveness of PDAC surveillance in this population requires further study. Prevention Relevance: BRCA1/BRCA2/ATM/PALB2 carriers have increased pancreatic ductal adenocarcinoma (PDAC) risk, yet are typically not eligible for PDAC surveillance in the absence of PDAC family history. Herein we describe outcomes of PDAC surveillance in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC, showing that PDAC surveillance can be considered in this high-risk group. |
Databáze: | OpenAIRE |
Externí odkaz: |