Breast Cancer Research and Treatment

, Volume 133, Issue 2, pp 735–740

Long-term follow-up of Jewish women with a BRCA1 and BRCA2 mutation who underwent population genetic screening

  • Kelly A. Metcalfe
  • Nida Mian
  • Melissa Enmore
  • Aletta Poll
  • Marcia Llacuachaqui
  • Sonia Nanda
  • Ping Sun
  • Kevin S. Hughes
  • Steven A. Narod
Epidemiology

DOI: 10.1007/s10549-011-1941-0

Cite this article as:
Metcalfe, K.A., Mian, N., Enmore, M. et al. Breast Cancer Res Treat (2012) 133: 735. doi:10.1007/s10549-011-1941-0

Abstract

There are two mutations in BRCA1 and one in BRCA2, which are present in up to 2.5% of Jewish women. Population genetic testing for Jewish women has been proposed; however, it is unclear how this would impact the uptake of cancer prevention options and psychosocial functioning in women with a positive result. Two thousand and eighty unselected Jewish women were tested for the Jewish BRCA mutations, and 1.1% were positive. Cancer-related distress was measured before testing, and at 1 and 2 years post-testing. Information on uptake of cancer risk reduction options was collected at 2 years. Breast and ovarian cancer risks were estimated using BRCAPRO. Within 2 years of receiving a positive result, 11.1% of women had prophylactic mastectomy, and 89.5% had a prophylactic oophorectomy. The mean breast cancer risk was estimated to be 37.2% at time of testing, compared to 20.9% at 2 years post-testing. The mean ovarian cancer risk was estimated to be 24.5% at time of testing, compared to 7.5% at 2 years following testing. Distress decreased between 1 and 2 years for women with prophylactic mastectomy and oophorectomy (P = 0.02), and for women with prophylactic oophorectomy only (P = 0.04) but not for those with neither surgery. The majority of Jewish women with a BRCA mutation identified through a population screening elected prophylactic oophorectomy, but a few had a prophylactic mastectomy. Uptake of either surgery resulted in decreased distress. Provision of population BRCA testing resulted in reduced risks of breast and ovarian cancers in women with a mutation.

Keywords

BRCA1BRCA2Breast cancerGenetic testingJewish

Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Kelly A. Metcalfe
    • 1
    • 2
  • Nida Mian
    • 2
  • Melissa Enmore
    • 2
  • Aletta Poll
    • 2
  • Marcia Llacuachaqui
    • 2
  • Sonia Nanda
    • 2
  • Ping Sun
    • 2
  • Kevin S. Hughes
    • 3
  • Steven A. Narod
    • 2
    • 4
  1. 1.Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoCanada
  2. 2.Women’s College Research InstituteTorontoCanada
  3. 3.Massachusetts General HospitalBostonUSA
  4. 4.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada