Guidelines for Follow-Up of Women at High Risk for Inherited Breast Cancer: Consensus Statement from the Biomed 2 Demonstration Programme on Inherited Breast Cancer
Article type: Research Article
Authors: Møller, P. | Evans, G. | Haites, N. | Vasen, H. | Reis, M.M. | Anderson, E. | Apold, J. | Hodgson, S. | Eccles, D. | Olsson, H. | Stoppa-Lyonnet, D. | Chang-Claude, J. | Morrison, P.J. | Bevilacqua, G. | Heimdal, K. | Mæhle, L. | Lalloo, F. | Gregory, H. | Preece, P. | Borg, Å. | Nevin, N.C. | Caligo, M. | Steel, C.M.
Affiliations: Unit of Medical Genetics, The Norwegian Radium Hospital, N-0310 Oslo, Norway | Family History Clinic, Centre for Cancer Epidemiology, Christie Hospital NHS Trust, Withington, Manchester M20 4QL, UK | Department of Medical Genetics, University of Aberdeen, Polworth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK | The Netherlands Foundation for the Detection of Hereditary Tumours, c/o University Hospital, Rijnsburgerweg 10, Building no 5, 2333 AA Leiden, The Netherlands | Departments of Surgery and Genetics, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK | Family History Clinic, Breast Screening Centre, Ardmillan Terrace, Edinburgh EH11 2JL, Scotland, UK | Department of Medical Genetics, Haukeland University Hospital, N-5521 Bergen, Norway | Division of Medical and Molecular Genetics, Guy's Hospital, London Bridge, London SE1 9RT, UK | Department of Human Genetics, Princess Ann Hospital, Southampton SO16 5YA, UK | Department of Oncology, University Hospital, SE-221 85 Lund, Sweden | Unité de Génétique Oncologique, Institut Curie, Section Medicale, 26, Rue d'Ulm 75231 Paris Cedex 05, France | Division of Epidemiology, German Cancer Research Centre, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany | Northern Ireland Regional Medical Genetics Centre, Belfast City Hospital Trust, Belfast, BT9 7AB, UK | Institute of Pathology, University of Pisa, via Roma 57, 56126 Pisa, Italy
Note: [] Correspondence: Pål Møller, Unit of Medical Genetics, The Norwegian Radium Hospital, N-0310 Oslo, Norway, Tel.: + 47 229 35675; Fax: + 47 229 35219; Email: [email protected]
Abstract: Protocols for activity aiming at early diagnosis and treatment of inherited breast or breast-ovarian cancer have been reported. Available reports on outcome of such programmes are considered here. It is concluded that the ongoing activities should continue with minor modifications. Direct evidence of a survival benefit from breast and ovarian screening is not yet available. On the basis of expert opinion and preliminary results from intervention programmes indicating good detection rates for early breast cancers and 5-year survival concordant with early diagnosis, we propose that women at high risk for inherited breast cancer be offered genetic counselling, education in 'breast awareness' and annual mammography and clinical expert examination from around 30 years of age. Mammography every second year may be sufficient from 60 years on. BRCA1 mutation carriers may benefit from more frequent examinations and cancer risk may be reduced by oophorectomy before 4050 years of age. We strongly advocate that all activities should be organized as multicentre studies subjected to continuous evaluation to measure the effects of the interventions on long-term mortality, to match management options more precisely to individual risks and to prepare the ground for studies on chemoprevention.
Journal: Disease Markers, vol. 15, no. 1-3, pp. 207-211, 1999
