Skip to main content
Log in

Das hereditäre Mammakarzinom

Hereditary breast cancer

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Gehäuftes Auftreten von Mamma- und Ovarialkarzinom in einer Familie gibt den ersten Hinweis für hereditär bedingte Tumoren. Angehörige betroffener Familien sollten spezialisierten Zentren zur interdisziplinären Beratung zugeführt werden. Bei Nachweis einer Mutation im BRCA1- oder BRCA2-Gen besteht ein bis zu 80%iges Lebenszeitrisiko, an einem Mammakarzinom zu erkranken. Die Kenntnis eines hereditären Zusammenhangs zwischen eigenen oder familiären Erkrankungsfällen hat Einfluss auf Vorsorge, Therapie und Nachsorge. Die nicht erkrankte Ratsuchende kann an einem intensivierten Früherkennungsprogramm teilnehmen und Präventionsstrategien überdenken. Bereits erkrankte Familienmitglieder können gezielt beraten und behandelt werden. Als neue spezifische Therapieansätze sind PARP(Poly-ADP-Ribose-Polymerase)-1-Inhibitoren und Platinderivate bereits in klinischer Prüfung. Die deutschlandweite Zusammenführung der Daten aller getesteten Familien durch das Konsortium für hereditäres Mamma- und Ovarialkarzinom ermöglicht klinische Forschung und die Teilnahme an der weltweiten Suche nach weiteren Risikogenen.

Abstract

About 10% of all breast cancer cases are of genetic origin. A positive family history for breast and/or ovarian cancer can strongly hint at a hereditary background. Mutation in BRCA1 or BRCA2 raises the relative lifetime risk of breast cancer to 80%. Furthermore, there is a significant risk of other mutation-associated cancers; the ovarian cancer lifetime risk is up to 45%. Knowledge of a hereditary cause for breast cancer in a patient’s own or family history influences early cancer detection, prevention strategies, therapy, and aftercare. New therapy options such as the PARP-1 inhibitor, the first specific and molecular target, and the use of platinum-based drug regimens to individualize treatment of BRCA-associated cancer are now being tested in clinical trials. The data for all families that have undergone genetic counseling are being collected by the German Consortium for Hereditary Breast and Ovarian Cancer to enable participation in clinical research and in the worldwide search for new high-risk genes

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1

Literatur

  1. Antoniou AC, Easton DF (2003) Polygenic inheritance of breast cancer: Implications for design of association studies. Genet Epidemiol 25(3):190–202

    Article  PubMed  Google Scholar 

  2. Antoniou AC, Pharoah PD, Narod S et al (2005) Breast and ovarian cancer risks to carriers of the BRCA1 5382insC and 185delAG and BRCA2 6174delT mutations: a combined analysis of 22 population based studies. J Med Genet 42(7):602–603

    Article  PubMed  CAS  Google Scholar 

  3. Byrski T, Gornwald J, Huzarski T et al (2008) The polish hereditary breast cancer consortium response to neo-adjuvant chemotherapy in women with BRCA1-positive breast cancers. Breast Cancer Res Treat 108:289–296

    Article  PubMed  CAS  Google Scholar 

  4. Cuzick J (2008) Chemoprevention of breast cancer. Breast Cancer 15(1):10–16

    Article  PubMed  Google Scholar 

  5. Fong PC, Boss DS, Carden CP et al (2008) AZD2281 (KU-0059436), a PARP (poly-ribose polymerase) inhibitor with single agent anticancer activity in patients with BRCA deficient ovarian cancer: Results from a phase I study. J Clin Oncol, ASCO 2008 Annual Meeting Proceedings (Post-Meeting Edition) 26:5510

  6. Hartmann LC, Sellers TA, Schaid DJ et al (2001) Efficacy of bilateral prophylactic mastectomy in BRCA1 and BRCA2 gene mutation carriers. J Natl Cancer Inst 7; 93(21):1633–1637

    Google Scholar 

  7. Husain A, He G, Venkatraman ES, Spriggs DR (1998) BRCA1 up-regulation is associated with repair-mediated resistance to cis-diamminedichloroplatinum(II). Cancer Res 15; 58(6):1120–1123

    Google Scholar 

  8. King MC, Marks JH, Mandell JB, New York Breast Cancer Study Group (2003) Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science 4; 302(5645):643–646

    Google Scholar 

  9. King MC, Wieand S, Hale K et al (2001) Tamoxifen and breast cancer incidence among women with inherited mutations in BRCA1 and BRCA2: National Surgical Adjuvant Breast and Bowel Project (NSABP-P1) Breast Cancer Prevention Trial. JAMA 286(18):2251–2256

    Article  PubMed  CAS  Google Scholar 

  10. Lafarge S, Sylvain V, Ferrara M, Bignon YJ (2201) Inhibition of BRCA1 leads to increased chemoresistance to microtubule-interfering agents, an effect that involves the JNK pathway. Oncogene 20(45):6597–6606

    Article  Google Scholar 

  11. Lakhani SR, Reis-Filho JS, Fulford L et al (2005) Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res 15; 11(14):5175–5180

    Google Scholar 

  12. Lostumbo L, Carbine N, Wallace J, Ezzo J (2004) Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev 18(4)

  13. Meijers-Heijboer H, van Geel B, van Putten WL et al (2001) Breast caner after prophylactic mastectomy in women with a personal and family history of breast cancer BRCA1 and BRCA2 mutation. N Eng J Med 345:159–164

    Article  CAS  Google Scholar 

  14. Metcalfe K, Lynch HT, Ghadirian P et al (2004) Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 15; 22(12):2328–2335

    Google Scholar 

  15. Metcalfe KA, Lynch HT, Ghadirian P et al (2005) The risk of ovarian cancer after breast cancer in BRCA1 and BRCA2 carriers. Gynecol Oncol 96(1):222–226

    Article  PubMed  CAS  Google Scholar 

  16. Metcalfe KA (2009) Oophorectomy for breast cancer prevention in women with BRCA1 or BRCA2 mutations. Womens Health (Lond Engl) 5(1):63–68. Review

    Google Scholar 

  17. Pierce LJ, Levin AM, Rebbeck TR et al (2006) Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1/2-associated stage I/II breast cancer. J Clin Oncol 1; 24(16):2437–2443

    Google Scholar 

  18. Quinn JE, Kennedy RD, Mullan PB et al (2003) BRCA1 functions as a differential modulator of chemotherapy-induced apoptosis. Cancer Res 1;63(19):6221–6228

    Google Scholar 

  19. Rebbeck TR, Friebel T, Lynch HT et al (2004) Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol 15; 22(6):1055–1062

    Google Scholar 

  20. Robson M, Svahn T, McCormick B et al (2005) Appropriateness of breast-conserving treatment of breast carcinoma in women with germline mutations in BRCA1 or BRCA2: a clinic-based series. Cancer 1; 103(1):44–51

    Google Scholar 

  21. Satagopan JM, Offit K, Foulkes W et al (2001) The lifetime risks of breast cancer in Ashkenazi Jewish carriers of BRCA1 and BRCA2 mutations. Cancer Epidemiol Biomarkers 10(5):467–473

    CAS  Google Scholar 

  22. Tassone P, Tagliaferri P, Perricelli A et al (2003) BRCA1 expression modulates chemosensitivity of BRCA1-defective HCC1937 human breast cancer cells. Br J Cancer 22; 88(8):1285–1291

    Google Scholar 

  23. van Sprundel TC, Schmidt MK, Rookus MA et al (2005) Risk reduction of contralateral breast cancer and survial after contralateral prophylactic mastectomy in BRCA1 or BRCA2 mutation carriers. Br J Cancer 8; 93(3):287–292

    Google Scholar 

  24. Yun J, Zhong Q, Kwak JY, Lee WH (2005) Hypersensitivity of Brca1-deficient MEF to the DNA interstrand crosslinking agent mitomycin C is associated with defect in homologous recombination repair and aberrant S-phase arrest. Oncogene 9; 24(25):4009–4016

    Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Crohns.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crohns, C., Mundhenke, C. Das hereditäre Mammakarzinom. Gynäkologe 42, 665–670 (2009). https://doi.org/10.1007/s00129-009-2360-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00129-009-2360-8

Schlüsselwörter

Keywords

Navigation