Abstract
In 2004 the NICE guidelines on familial breast cancer advised Health Care Professionals that they should not actively seek to identify women with a family history of breast cancer. We have carried out a review of the evidence base and a large scale questionnaire survey of health professionals in four European countries. There is overwhelming support amongst GPs and surgeons against the premise that that health care professionals should not be proactive in identifying patients at risk of familial breast cancer. This that suggest the time is right to overturn the NICE decision.
References
Grann VR, Jacobson JS, Thomason D et al (2002) Effect of prevention strategies on survival and quality-adjusted survival of women with BRCA1/2 mutations: an updated decision analysis. J Clin Oncol 20(10):2520–2529
van Roosmalen MS, Verhoef LC, Stalmeier PF et al (2002) Decision analysis of prophylactic surgery or screening for BRCA1 mutation carriers: a more prominent role for oophorectomy. J Clin Oncol 20(8):2092–2100
McIntosh A, Shaw C, Evans G, et al. (2004 updated 2006) Clinical guidelines and evidence review for the classification and care of women at risk of familial breast cancer. National Collaborating Centre for Primary Care/University of Sheffield, London. NICE guideline CG041. www.nice.org.uk
Leach MO, Boggis CR, Dixon AK et al (2005) Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 365(9473):1769–1778
Kriege M, Brekelmans CT, Boetes C et al (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 351(5):427–437
Evans DGR, Baildam AD, Anderson E et al (2009) Risk reducing mastectomy: outcomes in 10 European Centres. J Med Genet 46(4):254–258
Domchek SM, Friebel-Klingner TM, Neuhausen SL et al (2006) Mortality reduction after risk-reducing bilateral salpingo-oophorectomy in BRCA1 and BRCA2 mutation carriers. Lancet Oncol 7(3):223–229
Domchek SM, Friebel TM, Singer CF et al (2010) Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA 304(9):967–975
FH01 Management Committee, Steering Committee, Collaborators (2010) Tumour attributes and implications for future mortality in the FH01 study of mammographic surveillance in women aged 40–49 with a family history of breast cancer. Lancet Oncol 11(12):1127–1134
Acknowledgments
This work was supported by the German Bundesministerium für Bildung und Forschung (BMBF, Federal Ministry of Education and Research), contract number 01GP0617. Prof Evans is supported by the NIHR Biomedical Research Centre in Manchester. All authors declare that there are no competing interests.
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Harris, H., Nippert, I., Julian-Reynier, C. et al. Familial breast cancer: is it time to move from a reactive to a proactive role?. Familial Cancer 10, 501–503 (2011). https://doi.org/10.1007/s10689-011-9434-1
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DOI: https://doi.org/10.1007/s10689-011-9434-1