Breast cancer risks in individuals testing negative for a known family mutation in BRCA1 or BRCA2 Journal Article


Authors: Domchek, S. M.; Gaudet, M. M.; Stopfer, J. E.; Fleischut, M. H.; Powers, J.; Kauff, N.; Offit, K.; Nathanson, K. L.; Robson, M.
Article Title: Breast cancer risks in individuals testing negative for a known family mutation in BRCA1 or BRCA2
Abstract: Genetic testing for BRCA1 and BRCA2 mutations in family members of individuals with known deleterious mutations can distinguish between patients at high risk of disease and those who are not. Some studies have suggested that individuals testing negative for known familial mutations (true negatives), may still have a higher risk of breast cancer (BC) than the general population. We have examined a prospectively followed cohort of true negative women in the US. Subjects were close relatives of known BRCA1 and BRCA2 mutation carriers who had undergone genetic testing, were negative for the known familial mutation, and were unaffected at the time of genetic testing. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated using SEER incidence rates. Among 375 true negatives, two invasive and two in situ BC and no ovarian cancers were diagnosed with mean follow up of 4.9 years (total of 1,962 person-years). Four invasive BC were expected, whereas two were observed, for an age-adjusted SIR of 0.52 (95% CI 0.13-2.09). We observed more cases of in situ BC (n = 2) than were expected (n = 0.9; SIR = 2.30; 95% CI 0.57-9.19). There were no cases of ovarian cancer observed; 0.4 case was expected. In this prospective study of women who were unaffected at the time of genetic testing and who were negative for the known familial mutation in BRCA1/2, no excess risk of invasive BC was observed. Our data suggest that such women in the US should adhere to population-based guidelines for breast cancer screening. © 2009 Springer Science+Business Media, LLC.
Keywords: adult; controlled study; aged; middle aged; gene mutation; mutation; clinical trial; case report; cancer risk; united states; follow up; cancer diagnosis; cancer incidence; prospective studies; genetic analysis; phenotype; genetic predisposition to disease; chemoprophylaxis; ovary cancer; breast cancer; mastectomy; incidence; tumor markers, biological; risk factors; breast neoplasms; brca1 protein; brca2 protein; time factors; risk assessment; pedigree; gene expression regulation, neoplastic; practice guidelines as topic; predictive value of tests; neoplasm invasiveness; guideline adherence; brca1; brca2; genetic testing; phenocopy; standardized incidence ratio
Journal Title: Breast Cancer Research and Treatment
Volume: 119
Issue: 2
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2010-01-01
Start Page: 409
End Page: 414
Language: English
DOI: 10.1007/s10549-009-0611-y
PUBMED: 19885732
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: BCTRD" - "Source: Scopus"
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  1. Kenneth Offit
    788 Offit
  2. Mark E Robson
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  3. Noah Kauff
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  4. Mia Gaudet
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