The association of genetic testing timing and mutation type on breast cancer management in patients with breast cancer-related mutations.

Am J Surg

Department of Surgery, Duke University Medical Center, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address:

Published: January 2025

AI Article Synopsis

  • The study investigates how genetic mutations in breast cancer patients influence their treatment choices and management strategies.
  • It categorizes patients based on the type of mutation (BRCA1/2, high penetrance, moderate penetrance) and when they had genetic testing (at diagnosis or after treatment).
  • Results show that those tested at diagnosis preferred more aggressive surgeries like bilateral mastectomy, while those who had prior treatment mostly opted for surveillance.

Article Abstract

Background: We aim to characterize breast management for patients with genetic mutations and concurrent breast cancer (BC) or prior BC treatment.

Methods: Adults with a BC-related mutation and prior/concurrent BC diagnosis were identified. Groups were stratified by mutation type [BRCA1/2, high penetrance mutation (HPM), moderate penetrance mutation (MPM)] and timing of genetic testing (concurrent with BC versus after BC treatment). Outcomes were compared.

Results: Among 338 patients included, 63 ​% had BRCA1/2 mutations, 9 ​% HPM, and 28 ​% MPM. Approximately 38 ​% had testing concurrent with a BC diagnosis and 62 ​% after BC treatment. Patients with concurrent testing favored bilateral mastectomy (57 ​%) versus 26 ​% lumpectomy, and 16 ​% unilateral mastectomy, which varied by mutation type. Patients previously treated preferred surveillance (92 ​% vs. 8 ​% additional surgery), regardless of mutation type.

Conclusion: The timing of a significant BC-related genetic test result and mutation type may be associated with management decisions among patients with breast cancer.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649441PMC
http://dx.doi.org/10.1016/j.amjsurg.2024.116005DOI Listing

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