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• W4361948400 abstract "<div>Abstract<p><b>Background:</b> It is recommended that <i>BRCA1/2</i> mutation carriers undergo breast cancer screening using MRI because of their very high cancer risk and the high sensitivity of MRI in detecting invasive cancers. Clinical observations suggest important differences in the natural history between breast cancers due to mutations in <i>BRCA1</i> and <i>BRCA2</i>, potentially requiring different screening guidelines.</p><p><b>Methods:</b> Three studies of mutation carriers using annual MRI and mammography were analyzed. Separate natural history models for <i>BRCA1</i> and <i>BRCA2</i> were calibrated to the results of these studies and used to predict the impact of various screening protocols on detection characteristics and mortality.</p><p><b>Results:</b><i>BRCA1/2</i> mutation carriers (<i>N</i> = 1,275) participated in the studies and 124 cancers (99 invasive) were diagnosed. Cancers detected in <i>BRCA2</i> mutation carriers were smaller [80% ductal carcinoma <i>in situ</i> (DCIS) or ≤10 mm vs. 49% for <i>BRCA1</i>, <i>P</i> < 0.001]. Below the age of 40, one (invasive) cancer of the 25 screen-detected cancers in <i>BRCA1</i> mutation carriers was detected by mammography alone, compared with seven (three invasive) of 11 screen-detected cancers in <i>BRCA2</i> (<i>P</i> < 0.0001). In the model, the preclinical period during which cancer is screen-detectable was 1 to 4 years for BRCA1 and 2 to 7 years for <i>BRCA2</i>. The model predicted breast cancer mortality reductions of 42% to 47% for mammography, 48% to 61% for MRI, and 50% to 62% for combined screening.</p><p><b>Conclusions:</b> Our studies suggest substantial mortality benefits in using MRI to screen <i>BRCA1/2</i> mutation carriers aged 25 to 60 years but show important clinical differences in natural history.</p><p><b>Impact:</b> BRCA1 and BRCA2 mutation carriers may benefit from different screening protocols, for example, below the age of 40. <i>Cancer Epidemiol Biomarkers Prev; 21(9); 1458–68. ©2012 AACR</i>.</p></div>" @default.
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• W4361948400 date "2023-03-31" @default.
• W4361948400 modified "2023-09-27" @default.
• W4361948400 title "Data from Differences in Natural History between Breast Cancers in <i>BRCA1</i> and <i>BRCA2</i> Mutation Carriers and Effects of MRI Screening-MRISC, MARIBS, and Canadian Studies Combined" @default.
• W4361948400 doi "https://doi.org/10.1158/1055-9965.c.6515772.v1" @default.
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