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Management of BRCA1/2 associated breast cancer: A systematic qualitative review of the state of knowledge in 2006

par Liebens, Fabienne ;Carly, Birgit;Pastijn, Anne;Rozenberg, Serge
Référence European journal of cancer, 43, 2, page (238-257)
Publication Publié, 2007-01

Article révisé par les pairs

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Résumé :

Introduction: The optimal clinical management of breast cancer (BC) arising in BRCA1/2 mutations carriers is a difficult issue complicated by the risk of subsequent malignancies and by the potential differences in response to local and systemic therapies. Aim: Systematically review the difference in outcome after breast conservation therapy (BCT) and uni-or bilateral mastectomy in BRCA1/2 related BC. Material and methods: We selected 20 studies, for which we evaluated the methodology, the characteristics of the populations, biases, confounding risk factors and outcomes. Results: All studies are retrospective, entailed by numerous biases. They varied with respect to patients' number, selection, and confounding factors. Hereditary BC patients carried an increased risk of ipsilateral recurrence in 5/17 studies, a worse survival in 4/14, an increased risk of contralateral BC in 14/16. Conclusion: Except for contralateral risk, the presence of a BRCA mutation does not seem to offer additional prognostic information. Large prospective trials, stratified for risk reduction strategies are warranted. © 2006 Elsevier Ltd. All rights reserved.