The Burden of Breast Cancer Predisposition Variants Across The Age Spectrum Among 10 000 Patients.
Age Distribution
Age Factors
Aged
Biomarkers, Tumor
/ genetics
Breast Neoplasms
/ diagnosis
Female
Follow-Up Studies
Genetic Markers
/ genetics
Genetic Predisposition to Disease
Genetic Testing
Geriatric Assessment
/ methods
Humans
Latin America
/ epidemiology
Morbidity
/ trends
Prospective Studies
Registries
Risk Assessment
/ methods
United States
/ epidemiology
breast cancer
genetics
older women
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
23
01
2019
revised:
15
03
2019
accepted:
20
03
2019
pubmed:
24
4
2019
medline:
15
5
2020
entrez:
24
4
2019
Statut:
ppublish
Résumé
Women diagnosed with breast cancer (BC) at an older age are less likely to undergo genetic cancer risk assessment and genetic testing since the guidelines and referrals are biased toward earlier age at diagnosis. Thus, we determined the prevalence and type of pathogenic cancer predisposition variants among women with a history of BC diagnosed at the age of 65 years or older vs younger than 65 years. Prospective registration cohort. The Clinical Cancer Genomics Community Research Network, including 40 community-based clinics in the United States and 5 in Latin America. Women with BC and genetic testing results. Sociodemographic characteristics, clinical variables, and genetic profiles were compared between women aged 65 years and older and those younger than 65 years at BC diagnosis. Among 588 women diagnosed with BC and aged 65 years and older and 9412 diagnosed at younger than 65 years, BC-associated pathogenic variants (PVs) were detected in 5.6% of those aged 65 years and older (n = 33) and 14.2% of those younger than 65 years (n = 1340) (P < .01). PVs in high-risk genes (eg, BRCA1 and BRCA2) represented 81.1% of carriers among women aged 65 years and older (n = 27) and 93.1% of those younger than 65 years (n = 1248) (P = .01). BRCA2 PVs represented 42.4% of high-risk gene findings for those aged 65 years and older, whereas BRCA1 PVs were most common among carriers younger than 65 years (49.7%). PVs (n = 7) in moderate-risk genes represented 21.2% for carriers aged 65 years and older and 7.3% of those younger than 65 years (n = 98; P < .01). CHEK2 PVs were the most common moderate-risk gene finding in both groups. Clinically actionable BC susceptibility PVs, particularly in BRCA2 and CHEK2, were relatively prevalent among older women undergoing genetic testing. The significant burden of PVs for older women with BC provides a critical reminder to recognize the full spectrum of eligibility and provide genetic testing for older women, rather than exclusion based on chronological age alone. J Am Geriatr Soc 67:884-888, 2019.
Sections du résumé
BACKGROUND/OBJECTIVES
Women diagnosed with breast cancer (BC) at an older age are less likely to undergo genetic cancer risk assessment and genetic testing since the guidelines and referrals are biased toward earlier age at diagnosis. Thus, we determined the prevalence and type of pathogenic cancer predisposition variants among women with a history of BC diagnosed at the age of 65 years or older vs younger than 65 years.
DESIGN
Prospective registration cohort.
SETTING
The Clinical Cancer Genomics Community Research Network, including 40 community-based clinics in the United States and 5 in Latin America.
PARTICIPANTS
Women with BC and genetic testing results.
MEASUREMENTS
Sociodemographic characteristics, clinical variables, and genetic profiles were compared between women aged 65 years and older and those younger than 65 years at BC diagnosis.
RESULTS
Among 588 women diagnosed with BC and aged 65 years and older and 9412 diagnosed at younger than 65 years, BC-associated pathogenic variants (PVs) were detected in 5.6% of those aged 65 years and older (n = 33) and 14.2% of those younger than 65 years (n = 1340) (P < .01). PVs in high-risk genes (eg, BRCA1 and BRCA2) represented 81.1% of carriers among women aged 65 years and older (n = 27) and 93.1% of those younger than 65 years (n = 1248) (P = .01). BRCA2 PVs represented 42.4% of high-risk gene findings for those aged 65 years and older, whereas BRCA1 PVs were most common among carriers younger than 65 years (49.7%). PVs (n = 7) in moderate-risk genes represented 21.2% for carriers aged 65 years and older and 7.3% of those younger than 65 years (n = 98; P < .01). CHEK2 PVs were the most common moderate-risk gene finding in both groups.
CONCLUSION
Clinically actionable BC susceptibility PVs, particularly in BRCA2 and CHEK2, were relatively prevalent among older women undergoing genetic testing. The significant burden of PVs for older women with BC provides a critical reminder to recognize the full spectrum of eligibility and provide genetic testing for older women, rather than exclusion based on chronological age alone. J Am Geriatr Soc 67:884-888, 2019.
Identifiants
pubmed: 31012959
doi: 10.1111/jgs.15937
pmc: PMC6524775
mid: NIHMS1022085
doi:
Substances chimiques
Biomarkers, Tumor
0
Genetic Markers
0
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
884-888Subventions
Organisme : NCI NIH HHS
ID : RC4 CA153828
Pays : United States
Organisme : NIH HHS
ID : RC4 CA153828
Pays : United States
Organisme : Breast Cancer Research Foundation
Pays : International
Organisme : NCI NIH HHS
ID : K08 CA234394
Pays : United States
Organisme : Dr. Norman and Melinda Payson Professorship in Medical Oncology
Pays : International
Informations de copyright
© 2019 The American Geriatrics Society.
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