Management of BRCA1/2 associated breast cancer: a systematic qualitative review of the state of knowledge in 2006.
BACKGROUND
The optimal clinical management of breast cancer (BC) arising in BRCA1/2 mutations carriers is a difficult issue complicated by the risk of subsequent malignancies and by the potential differences in response to local and systemic therapies.


OBJECTIVE
Systematically review the difference in outcome after breast conservation therapy (BCT) and uni-or bilateral mastectomy in BRCA1/2 related BC.


METHODS
We selected 20 studies, for which we evaluated the methodology, the characteristics of the populations, biases, confounding risk factors and outcomes.


RESULTS
All studies are retrospective, entailed by numerous biases. They varied with respect to patients' number, selection, and confounding factors. Hereditary BC patients carried an increased risk of ipsilateral recurrence in 5/17 studies, a worse survival in 4/14, an increased risk of contralateral BC in 14/16.


CONCLUSIONS
Except for contralateral risk, the presence of a BRCA mutation does not seem to offer additional prognostic information. Large prospective trials, stratified for risk reduction strategies are warranted.
Liebens
Fabienne Patricia
FP
Department OB/Gyn - St. Pierre University Hospital, Haute Str. 290, 1000 Brussels, Belgium. fabienne.liebens@chello.be
Carly
Birgit
B
Pastijn
Ann
A
Rozenberg
Serge
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D016019:Survival Analysis; D016896:Treatment Outcome