Regular screening of young women with BRCA1/2 genes can detect breast cancers

Eisinger, Dr François MD
Sobol, Professor Hagay MD, PhD

Paoli-Calmettes Institute and Université de la Méditerranée, Marseille, France

Abstracted from:Brekelmans CTM, Seynaeve C, Bartels CCM, Tilanus-Linthorst MMA, Meijers-Heijboer EJ, Crepin CMG, van Geel AN, Menke M, Verhoog LC, Van den Ouweland A, Obdeijn IM, Klijn JGM. Effectiveness of breast cancer surveillance in BRCA1/2 gene mutation carriers and women with high familial risk. J Clin Oncol 2001; 19(4): 924-930 .

Evidence-based Healthcare 6(1):p 3-4, March 2002.

BACKGROUND

Breast cancer screening is cost-effective in 50-70-year-old women, but less cost-effective for under 40-year olds, who have lower rates of breast cancer. BRCA1/2 gene mutations have a proven link with breast cancer. Screening younger women with these mutations may be cost-effective.

OBJECTIVE

To examine the effects on invasive breast cancer detection rates of an intensive screening programme for under 50-year-old BRCA1/2 carriers.

SETTING

Netherlands; 1978-2000.

METHOD

Prospective and retrospective observational study.

PARTICIPANTS

One thousand, one hundred and ninety-eight women aged over 25 years or from high risk families with early onset breast cancer history; 52% at high risk of breast cancer; 11% with BRCA1/2 genes.

INTERVENTION

Breast self-examination monthly; clinical breast examination 6 monthly; annual mammography. Follow-up over median of 3 years.

OUTCOMES

Invasive breast cancer detection.

MAIN RESULTS

Average detection rate was 9.7 per 1000 women over the 3 year follow-up period. Detection rates were 3.3, 8.4 and 33 per 1000 women for moderate risk, high risk and BRCA1/2 carriers, respectively (Table 1).

Table 1 Invasive breast cancers detected during screening in women with different risks
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AUTHORS' CONCLUSIONS

An intensive breast cancer screening programme is cost-effective for younger women who are BRCA1/2 gene mutation carriers.