Prevalence of BRCA1 and BRCA2 germline mutations in young breast cancer patients: a population-based study.
Our aim was to estimate the prevalence of mutations in the BRCA1 and BRCA2 genes among unselected incident cases of breast cancer in young women. We identified 158 incident breast cancer cases diagnosed before age 46 years in predefined geographic areas in Girona and Tarragona, Spain, during 1995-1997. Of these, 136 (86%) provided information on family history of cancer and were screened for BRCA1 and BRCA2 mutations. Nine of the 136 (6.6%) were found to carry BRCA deleterious mutations (MUT) (1 BRCA1 and 8 BRCA2), and 20 were detected with rare BRCA variants of unknown significance (UV). Both MUT and US BRCA alterations were more frequent in younger patients: 7 (11.6%) MUT and 12 (19.3%) UV carriers were found in the group of 62 patients younger than 40 years, whereas 2 (2.7%) MUT and 9 (12%) US carriers were identified in the group of 74 patients aged 40-45. Family history of breast and ovarian cancers suggestive of hereditary condition (at least 2 first- or second-degree relatives affected with breast cancer or at least 1 relative affected with ovarian cancer or early-onset breast cancer) was absent for 5 of 9 MUT carriers. This suggests that BRCA screening policies based on family history of cancer would miss a considerable proportion of BRCA mutations. Mutations in the BRCA1 and BRCA2 genes explain at least 10% of breast cancer cases diagnosed before age 40 years. The contribution of these genes to early-onset breast cancer is likely to be even higher given that certain UV cases might be disease-associated.
de Sanjosé
Silvia
S
Institut Català d'Oncologia, Hospitalet de LL, Barcelona, Spain.
Léoné
Mélanie
M
International Agency for Research on Cancer, Lyon, France.
Bérez
Victoria
V
Servei d'Oncologia, Hospital Universitari Sant Joan y Universitat Rovira i Virgili, Reus, Spain.
Izquierdo
Angel
A
Unitat d'Epidemiologia i Registre del Càncer de Girona, Girona, Spain.
Font
Rebeca
R
Institut Català d'Oncologia, Hospitalet de LL, Barcelona, Spain.
Brunet
Joan M
JM
Servei d'Oncologia, Hospital Universitari Sant Joan y Universitat Rovira i Virgili, Reus, Spain.
Louat
Thierry
T
International Agency for Research on Cancer, Lyon, France.
Vilardell
Loreto
L
Unitat d'Epidemiologia i Registre del Càncer de Girona, Girona, Spain.
Borras
Joan
J
Servei d'Oncologia, Hospital Universitari Sant Joan y Universitat Rovira i Virgili, Reus, Spain.
Viladiu
Pau
P
Unitat d'Epidemiologia i Registre del Càncer de Girona, Girona, Spain.
Bosch
F Xavier
FX
Institut Català d'Oncologia, Hospitalet de LL, Barcelona, Spain.
Lenoir
Gilbert M
GM
International Agency for Research on Cancer, Lyon, France.|Institut Gustave Roussy, Villejuif, France.
Sinilnikova
Olga M
OM
International Agency for Research on Cancer, Lyon, France.|Laboratoire de Genetique, Hospices Civils de Lyon, Lyon, France.
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D018095:Germ-Line Mutation / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
D004273:DNA, Neoplasm