ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2012
Online tool to guide decisions for BRCA1/2 mutation carriers.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed.
- The effectiveness of a graphical presentation in addition to a frequency format in the context of familial breast cancer risk communication: a multicenter controlled trial.BMC medical informatics and decision making · 2013Trial
- Graphical Perception of Icon Arrays versus Bar Charts for Value Comparisons in Health Risk Communication.IEEE transactions on visualization and computer graphics · 2026Article
- Monte Carlo Tree Search for optimal cancer intervention strategies among BRCA mutation carriers.Computers in biology and medicine · 2025Article
- Pathogenic Variants, Family History, and Cumulative Risk of Breast Cancer in US Women.JAMA oncology · 2025Article
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- Hereditary ovarian cancer risk reduction: a retrospective evaluation of patient perspectives and service provision at a regional hereditary gynaecologic cancer clinic 2006-2016.BMC women's health · 2022Article
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- Decision Aids for Preventive Treatment Alternatives forGeburtshilfe und Frauenheilkunde · 2021Article
- Executive Summary of the Early-Onset Breast Cancer Evidence Review Conference.Obstetrics and gynecology · 2020Review
- Development and Testing of a Decision Aid for Unaffected Women with a BRCA1 or BRCA2 Mutation.Journal of cancer education : the official journal of the American Association for Cancer Education · 2020Article
- Do Preferred Risk Formats Lead to Better Understanding? A Multicenter Controlled Trial on Communicating Familial Breast Cancer Risks Using Different Risk Formats.Patient preference and adherence · 2020Article
- Simulation Modeling to Extend Clinical Trials of Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Early Breast Cancer.JNCI cancer spectrum · 2019Article
- Should unaffected female BRCA2 pathogenic variant carriers be told there is little or no advantage from risk reducing mastectomy?Familial cancer · 2019Article
- Survival after bilateral risk-reducing mastectomy in healthy BRCA1 and BRCA2 mutation carriers.Breast cancer research and treatment · 2019Article
- The Imperative for Patient-Centered Clinical Decision Support.EGEMS (Washington, DC) · 2018Article
- Estimating Breast Cancer Survival by Molecular Subtype in the Absence of Screening and Adjuvant Treatment.Medical decision making : an international journal of the Society for Medical Decision Making · 2018Article
- Cost Effectiveness of Gene Expression Profile Testing in Community Practice.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018Article
- Use of the BOADICEA Web Application in clinical practice: appraisals by clinicians from various countries.Familial cancer · 2018Article
- Decision making for breast cancer prevention among women at elevated risk.Breast cancer research : BCR · 2017Review
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Authors and funding
8 authors.
Funding
Abstract
purposeWomen with BRCA1 or BRCA2 (BRCA1/2) mutations must choose between prophylactic surgeries and screening to manage their high risks of breast and ovarian cancer, comparing options in terms of cancer incidence, survival, and quality of life. A clinical decision tool could guide these complex choices.
methodsWe built a Monte Carlo model for BRCA1/2 mutation carriers, simulating breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years and prophylactic mastectomy (PM) and/or prophylactic oophorectomy (PO) at various ages. Modeled outcomes were cancer incidence, tumor features that shape treatment recommendations, overall survival, and cause-specific mortality. We adapted the model into an online tool to support shared decision making.
resultsWe compared strategies on cancer incidence and survival to age 70 years; for example, PO plus PM at age 25 years optimizes both outcomes (incidence, 4% to 11%; survival, 80% to 83%), whereas PO at age 40 years plus MRI screening offers less effective prevention, yet similar survival (incidence, 36% to 57%; survival, 74% to 80%). To characterize patients' treatment and survivorship experiences, we reported the tumor features and treatments associated with risk-reducing interventions; for example, in most BRCA2 mutation carriers (81%), MRI screening diagnoses stage I, hormone receptor-positive breast cancers, which may not require chemotherapy.
conclusionCancer risk-reducing options for BRCA1/2 mutation carriers vary in their impact on cancer incidence, recommended treatments, quality of life, and survival. To guide decisions informed by multiple health outcomes, we provide an online tool for joint use by patients with their physicians (http://brcatool.stanford.edu).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.