Evidence map›Paper›PMID 38261128›Full record

ArticleAnnals of surgical oncology2024

Upgrade Rates and Breast Cancer Development Among Germline Pathogenic Variant Carriers with High-Risk Breast Lesions.

Alison Laws, Saskia Leonard, Emma Hershey, Samantha Stokes, Julie Vincuilla, Eshita Sharma, Kara Milliron, Judy E Garber, Sofia D Merajver, Tari A King and 1 more

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alison LawsDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Saskia LeonardDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Emma HersheyDepartment of Surgery, Michigan Medicine, Ann Arbor, MI, USA.
Samantha StokesDivision of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA.
Julie VincuillaDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Eshita SharmaDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Kara MillironBreast and Ovarian Cancer Risk Evaluation Program, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA.
Judy E GarberBreast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Sofia D MerajverBreast and Ovarian Cancer Risk Evaluation Program, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA.
Tari A KingDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Melissa L PilewskieDepartment of Surgery, Michigan Medicine, Ann Arbor, MI, USA. mpilewsk@med.umich.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-risk lesions (HRL) of the breast are risk factors for future breast cancer development and may be associated with a concurrent underlying malignancy when identified on needle biopsy; however, there are few data evaluating HRLs in carriers of germline pathogenic variants (PVs) in breast cancer predisposition genes.

methodsWe identified patients from two institutions with germline PVs in high- and moderate-penetrance breast cancer predisposition genes and an HRL in an intact breast, including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and lobular neoplasia (LN). We calculated upgrade rates at surgical excision and used Kaplan-Meier methods to characterize 3-year breast cancer risk in patients without upgrade.

resultsOf 117 lesions in 105 patients, 65 (55.6%) were ADH, 48 (41.0%) were LN, and 4 (3.4%) were FEA. Most PVs (83.8%) were in the BRCA1/2, CHEK2 and ATM genes. ADH and FEA were excised in most cases (87.1%), with upgrade rates of 11.8% (95% confidence interval [CI] 5.5-23.4%) and 0%, respectively. LN was selectively excised (53.8%); upgrade rate in the excision group was 4.8% (95% CI 0.8-22.7%), and with 20 months of median follow-up, no same-site cancers developed in the observation group. Among those not upgraded, the 3-year risk of breast cancer development was 13.1% (95% CI 6.3-26.3%), mostly estrogen receptor-positive (ER +) disease (89.5%).

conclusionsUpgrade rates for HRLs in patients with PVs in breast cancer predisposition genes appear similar to non-carriers. HRLs may be associated with increased short-term ER+ breast cancer risk in PV carriers, warranting strong consideration of surgical or chemoprevention therapies in this population.

Indexed as

Breast NeoplasmsCarcinoma in SituCarcinoma, Intraductal, NoninfiltratingPrecancerous ConditionsBiopsy, Large-Core NeedleBRCA1 ProteinBRCA2 ProteinBreastFemaleGerm CellsHumansRetrospective StudiesBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanAtypical ductal hyperplasiaAtypical lobular hyperplasiaBRCAGermline mutation carrierHigh-risk lesionLobular carcinoma in situPathogenic variant

Identifiers

PMID38261128

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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.