BRCA testing rates in young women with breast cancer increase

BRCA testing rates in young women with breast cancer increase

There has been a rise in rates of genetic testing for BRCA1 and BRCA2 mutations among women diagnosed with breast cancer at age 40 or younger. The above finding is published in an article published online by JAMA Oncology.

Breast cancer is the most common cancer diagnosed in women younger than 40 in the United States. The National Comprehensive Cancer Network guidelines recommend women diagnosed with breast cancer at 50 or younger undergo genetic testing because carriers of BRCA1 and BRCA2 mutations are at increased risk for developing early-onset breast cancer.

Eighty-seven percent, or 780 of 897 women with breast cancer at 11 academic and community medical centers, reported BRCA testing by a year after their disease diagnosis, while only 13 percent or 117 women had not undergone the genetic testing.

Assessing a young women's genetic risk after a breast cancer diagnosis can have implications for subsequent treatment decisions.

Ann H. Partridge, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, and co-authors described the use of BRCA testing in a group of women diagnosed with breast cancer at 40 or younger and examined how concerns about genetic risk and genetic information affected treatment decisions.

The study included 897 women 40 and younger diagnosed with breast cancer at 11 academic and community medical centers.

A total of 248 (29.8 percent) of 831 patients who were tested and reported a positive or negative result reported that knowledge or concern about the genetic risk of breast cancer influenced their treatment in some way.

Among those women, 76 of 88 mutation carriers (86.4 percent) and 82 of 160 non-carriers (51.2 percent) opted for a bilateral mastectomy to remove both breasts. Carriers of a mutation also were more likely to have undergone a salpingo-oophorectomy (ovary removal) than non-carriers.

The authors attribute the high frequency of BRCA testing likely to the fact that most women in the group were insured, educated and treated at cancer centers where comprehensive genetic counseling and testing services were widely available. There is also the possibility that media attention to genetic breast cancer (i.e. the Angelina Jolie effect) may have caused more women to bring up the issue of genetic risk with their physician or genetic counselor.

Additionally, the authors note bilateral mastectomy was still relatively common even among non-carriers suggesting that many women might choose to remove both breasts because of worries about developing another breast cancer and for peace of mind despite knowing they do not carry a known BRCA mutation.

Given that knowledge and concern about genetic risk influence surgical decisions and may affect systemic therapy trial eligibility, all young women with breast cancer should be counseled and offered genetic testing, consistent with the National Comprehensive Cancer Network guidelines, the study concludes.

It has been stated that the article should be seen for complete information.

BRCA testing rates in young women with breast cancer increase