Topics:
Breast Cancer • Gynecologic Cancers • Medical Oncology • Ovarian Cancer • ASCO Journal Club • Cancer Prevention • Cancer Predisposition
When, if ever, would you recommend risk reducing BSO in patients with moderate penetrance breast cancer germline mutations?
Genes such as ATM, CHEK2, PALB2, RAD51C/D, BRIP1 seem to show some potential increased risk of ovarian cancer. Should these patients under prophylactic oopherectomy or screening?
See JCO OGR 8/2021 by @Mark E. Robson discussing management of non-BRCA pathogenic variants, and companion study (Kraft et al, 8/2021) evaluating the role of further characterization of polygenic risk score.
Answer from: Medical Oncologist at Academic Institution
RAD51C, RAD51D, and BRIP1 are all associated with significant risks of ovarian cancer and are appropriate for consideration of prophylactic oophorectomy, albeit perhaps at a slightly later age than BRCA1 and BRCA2. ATM and PALB2 may be associated with ovarian cancer risks that are similar to that of...
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Answer from: Medical Oncologist at Academic Institution
While the risk of ovarian cancer with those mutations is not as high as for BRCA1, there does seem to be some risk. We also need to remember that RR BSO prior to menopause also reduces the risk of breast cancer. I would consider RR BSO in those patients whenever they have completed childbearing, max...