Awareness and Candidacy for Endocrine Prevention and Risk Reducing Mastectomy in Unaffected High-Risk Women Referred for Breast Cancer Risk Assessment.

Breast neoplasms Endocrine prevention Genetics High-risk lesions Risk-reducing surgery

Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
16 Nov 2023
Historique:
received: 09 08 2023
accepted: 22 10 2023
medline: 17 11 2023
pubmed: 17 11 2023
entrez: 16 11 2023
Statut: aheadofprint

Résumé

Primary prevention of breast cancer in women at elevated risk includes several strategies such as endocrine prevention and risk-reducing mastectomy (RRM). The objective of this study was to evaluate awareness of different preventive strategies across high-risk subgroups. Women referred for high risk evaluation between 2020 and 2023 completed an initial risk-assessment questionnaire that included questions around perceived lifetime risk and consideration of preventive strategies. One-way analysis of variance (ANOVA) and chi-squared tests were used to compare differences across different high-risk subgroups. 482 women with a median age of 43 years (20-79 years) met inclusion criteria; 183 (38.0%) germline pathogenic variant carriers (GPV), 90 (18.7%) with high-risk lesions (HRL) on breast biopsy, and 209 (43.4%) with strong family history (FH) without a known genetic predisposition. Most high-risk women reported that they had considered increased screening and surveillance (83.7%) and lifestyle strategies (80.6%), while fewer patients had considered RRM (39.8%) and endocrine prevention (27.0%). Prior to initial consultation, RRM was more commonly considered in GPV carriers (59.4%) relative to those with HRL (33.3%) or strong FH (26.3%, p < 0.001). Based on current guidelines, 206 (43%) patients were deemed eligible for endocrine prevention, including 80.5% with HRL and 39.0% with strong FH. Prior consideration of endocrine prevention was highest in patients with HRL and significantly lower in those with strong FH (47.2% HRL versus 31.1% GPV versus 18.7% FH, p = 0.001). Endocrine prevention is the least considered preventive option for high-risk women, despite eligibility in a significant proportion of those presenting with HRL or strong FH.

Identifiants

DOI: 10.1245/s10434-023-14566-1 PMID: 37973648
pubmed: 37973648
doi: 10.1245/s10434-023-14566-1
pii: 10.1245/s10434-023-14566-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Fonds de Recherche du Québec - Santé
ID : 309854

Informations de copyright

© 2023. Society of Surgical Oncology.

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Auteurs

Basmah Alhassan (B)

Department of Surgery, McGill University Medical School, Montreal, Canada.
Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Oncology, McGill University Medical School, Montreal, Canada.

Marianne Bou Rjeily (MB)

Department of Surgery, McGill University Medical School, Montreal, Canada.
Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.

Victor Villareal-Corpuz (V)

Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.

Ipshita Prakash (I)

Department of Surgery, McGill University Medical School, Montreal, Canada.
Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.
Department of Oncology, McGill University Medical School, Montreal, Canada.

Mark Basik (M)

Department of Surgery, McGill University Medical School, Montreal, Canada.
Department of Oncology, McGill University Medical School, Montreal, Canada.

Jean Francois Boileau (JF)

Department of Surgery, McGill University Medical School, Montreal, Canada.

Karyne Martel (K)

Department of Surgery, McGill University Medical School, Montreal, Canada.

Michael Pollak (M)

Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.
Department of Oncology, McGill University Medical School, Montreal, Canada.

William D Foulkes (WD)

Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.
Department of Oncology, McGill University Medical School, Montreal, Canada.
Division of Human Genetics, McGill University Medical School, Montreal, Canada.

Stephanie M Wong (SM)

Department of Surgery, McGill University Medical School, Montreal, Canada. sm.wong@mcgill.ca.
Stroll Cancer Prevention Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada. sm.wong@mcgill.ca.
Department of Oncology, McGill University Medical School, Montreal, Canada. sm.wong@mcgill.ca.

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