Affiliations: [a] Fisher Center for Familial Cancer Research, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA | [b] Norton Cancer Institute, Louisville, KY, USA | [x] Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, USA | [y] Clinical Trial Evaluation Program (CTEP), National Cancer Institute, Bethesda MD, USA
Correspondence:
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Corresponding author: Beth N. Peshkin, Fisher Center for Familial Cancer Research, Georgetown University, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007-2401, USA. Tel.: +1 202 687 2716; Fax: +1 202 687 0305; E-mail: peshkinb@georgetown.edu
Abstract: Identifying breast cancer patients at increased risk for carrying a mutation in the BRCA1 and BRCA2 genes is an important objective in clinical practice. Although age at diagnosis, family history of breast and/or ovarian cancer, and ethnicity are all essential parameters to consider when assessing risk, there are limitations as to how well such factors accurately predict BRCA1/2 status, even when quantitative risk models are applied. Integrating information about triple negative (TN) disease may help refine these estimates. Among newly diagnosed breast cancer patients, fewer than 10% have a mutation in the BRCA1 or BRCA2 genes, and up to 20% present However, among BRCA1 mutation carriers at least one-third have TN breast cancers. In this paper, we review key studies that have assessed breast cancer cases with a known BRCA1/2 status and triple marker data. We also discuss how integrating such information into qualitative and quantitative risk assessments of BRCA1/2 carrier probability may improve the ability to identify women who are appropriate candidates for genetic testing. Identifying women at increased risk is critical as knowledge of mutation status may impact surgical and systemic treatment in newly diagnosed patients, as well as recommendations for ovarian cancer risk management.
