Hereditary breast cancer growth rates and its impact on screening policy

Imaging is often performed yearly for the surveillance of BRCA1/2 mutation carriers and women at high familial breast cancer risk. Growth of cancers in carriers may be faster as these tumours are predominantly high grade. Quantitative data on tumour growth rates in these 2 groups are lacking. Here,...

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Bibliographic Details
Published in:European journal of cancer (1990) 2005-07, Vol.41 (11), p.1610-1617
Main Authors: Tilanus-Linthorst, Madeleine M.A., Kriege, Mieke, Boetes, Carla, Hop, Wim C.J., Obdeijn, Inge-Marie, Oosterwijk, Jan C., Peterse, Hans L., Zonderland, Harmine M., Meijer, Sybren, Eggermont, Alexander M.M., de Koning, Harry J., Klijn, Jan G.M., Brekelmans, Cecile T.M.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
BRCA1
Breast cancer
Breast Neoplasms - genetics
Breast Neoplasms - pathology
Carcinoma, Ductal, Breast - genetics
Carcinoma, Ductal, Breast - pathology
Cell Division
Familial breast cancer
Female
Genes, BRCA1
Genes, BRCA2
Genetic Testing - methods
Growth rate
Heterozygote
Humans
Interval cancer
Magnetic Resonance Imaging
Mammography
Medical sciences
Menopause
Middle Aged
MRI
Multivariate Analysis
Pharmacology. Drug treatments
Screening
Sojourn time
Surveillance
Survival Analysis
Tumors
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Summary:Imaging is often performed yearly for the surveillance of BRCA1/2 mutation carriers and women at high familial breast cancer risk. Growth of cancers in carriers may be faster as these tumours are predominantly high grade. Quantitative data on tumour growth rates in these 2 groups are lacking. Here, we have examined 80 high-risk women under surveillance for tumour size at diagnosis and preceding examinations at mammography and/or MRI. Tumour volume doubling time (DT) was assessed in 30 cancers in BRCA1/2 mutation carriers and 25 non-carriers. Impact of age and menopausal status were also evaluated. Mean DT of all invasive cancers was shorter in carriers (45 days CI: 26–73) than non-carriers (84 days CI: 58–131) ( P = 0.048). Mean age at diagnosis was lower in carriers (40 years) than non-carriers (45 years) ( P = 0.007). At multivariable analysis only age ( P = 0.03), not risk-group ( P = 0.26) nor menopause ( P = 0.58) correlated significantly with DT. The mean growth rate slowed down to half in each successive 10 years-older group. In conclusion, age at detection indicated the growth rates of hereditary and familial breast cancers. It is recommended that the screening frequency should be adjusted according to a woman’s age and a high-sensitive biannual test may be appropriate before the age of 40 years.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2005.02.034