Are BRCA1 and BRCA2 gene mutation patients underscreened for pancreatic adenocarcinoma?
Background Breast cancer (BRCA) mutations account for the highest proportion of hereditary causes of pancreatic ductal adenocarcinoma (PDAC). Screening is currently recommended only for patients with one first‐degree relative or two family members with PDAC. We hypothesized that screening all BRCA1/...
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| Veröffentlicht in: | Journal of surgical oncology 2019-05, Vol.119 (6), p.777-783 |
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| container_title | Journal of surgical oncology |
| container_volume | 119 |
| creator | Roch, Alexandra M. Schneider, Justine Carr, Rosalie A. Lancaster, William P. House, Michael G. Zyromski, Nicholas J. Nakeeb, Attila Schmidt, C. Max Ceppa, Eugene P. |
| description | Background
Breast cancer (BRCA) mutations account for the highest proportion of hereditary causes of pancreatic ductal adenocarcinoma (PDAC). Screening is currently recommended only for patients with one first‐degree relative or two family members with PDAC. We hypothesized that screening all BRCA1/2 patients would identify a higher rate of pancreatic abnormalities.
Methods
All BRCA1/2 patients at a single academic center were retrospectively reviewed (2005‐2015). Pancreatic abnormalities were defined on cross‐sectional imaging as pancreatic neoplasm (cystic/solid) or main‐duct dilation.
Results
Two hundred and four patients were identified with BRCA mutations. Forty‐seven (40%) had abdominal imaging (20 computerized tomography and 27 magnetic resonance imaging). Twenty‐one percent had pancreatic abnormalities (PDAC [n = 2] and intraductal papillary mucinous neoplasm [IPMN; n = 8]). The prevalence of pancreatic abnormalities and IPMN was higher in BRCA2 patients than in the general population (21% vs 8% and 17% vs 1%; P = 0.0007 and P |
| doi_str_mv | 10.1002/jso.25376 |
| format | Article |
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Breast cancer (BRCA) mutations account for the highest proportion of hereditary causes of pancreatic ductal adenocarcinoma (PDAC). Screening is currently recommended only for patients with one first‐degree relative or two family members with PDAC. We hypothesized that screening all BRCA1/2 patients would identify a higher rate of pancreatic abnormalities.
Methods
All BRCA1/2 patients at a single academic center were retrospectively reviewed (2005‐2015). Pancreatic abnormalities were defined on cross‐sectional imaging as pancreatic neoplasm (cystic/solid) or main‐duct dilation.
Results
Two hundred and four patients were identified with BRCA mutations. Forty‐seven (40%) had abdominal imaging (20 computerized tomography and 27 magnetic resonance imaging). Twenty‐one percent had pancreatic abnormalities (PDAC [n = 2] and intraductal papillary mucinous neoplasm [IPMN; n = 8]). The prevalence of pancreatic abnormalities and IPMN was higher in BRCA2 patients than in the general population (21% vs 8% and 17% vs 1%; P = 0.0007 and P < 0.0001, respectively), with no influence of family history. Similarly, BRCA1 patients had an increased prevalence of IPMN (8.3% vs 1%; P < 0.0001).
Conclusions
In this series, 4% and 17% of BRCA2 patients developed PDAC and IPMN, respectively. Eight percent of BRCA1 patients developed IPMN. Under current recommended screening, 60% of BRCA1/2 patients had incompletely pancreatic assessment. With no influence of family history, this study suggests all BRCA1/2 patients should undergo a high‐risk screening protocol that will identify a higher rate of precancerous pancreatic neoplasms amenable to curative resection.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25376</identifier><identifier>PMID: 30636051</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Breast cancer ; breast cancer mutation ; Cancer surgery ; intraductal papillary mucinous neoplasm ; Medical imaging ; Mutation ; pancreatic adenocarcinoma ; Pancreatic cancer ; screening ; Tumors</subject><ispartof>Journal of surgical oncology, 2019-05, Vol.119 (6), p.777-783</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4196-82599118c426dc78880b30b38282908021143ee353ea5d76682aa3f69c8e54813</citedby><cites>FETCH-LOGICAL-c4196-82599118c426dc78880b30b38282908021143ee353ea5d76682aa3f69c8e54813</cites><orcidid>0000-0002-7835-3370</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.25376$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.25376$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30636051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roch, Alexandra M.</creatorcontrib><creatorcontrib>Schneider, Justine</creatorcontrib><creatorcontrib>Carr, Rosalie A.</creatorcontrib><creatorcontrib>Lancaster, William P.</creatorcontrib><creatorcontrib>House, Michael G.</creatorcontrib><creatorcontrib>Zyromski, Nicholas J.</creatorcontrib><creatorcontrib>Nakeeb, Attila</creatorcontrib><creatorcontrib>Schmidt, C. Max</creatorcontrib><creatorcontrib>Ceppa, Eugene P.</creatorcontrib><title>Are BRCA1 and BRCA2 gene mutation patients underscreened for pancreatic adenocarcinoma?</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Breast cancer (BRCA) mutations account for the highest proportion of hereditary causes of pancreatic ductal adenocarcinoma (PDAC). Screening is currently recommended only for patients with one first‐degree relative or two family members with PDAC. We hypothesized that screening all BRCA1/2 patients would identify a higher rate of pancreatic abnormalities.
Methods
All BRCA1/2 patients at a single academic center were retrospectively reviewed (2005‐2015). Pancreatic abnormalities were defined on cross‐sectional imaging as pancreatic neoplasm (cystic/solid) or main‐duct dilation.
Results
Two hundred and four patients were identified with BRCA mutations. Forty‐seven (40%) had abdominal imaging (20 computerized tomography and 27 magnetic resonance imaging). Twenty‐one percent had pancreatic abnormalities (PDAC [n = 2] and intraductal papillary mucinous neoplasm [IPMN; n = 8]). The prevalence of pancreatic abnormalities and IPMN was higher in BRCA2 patients than in the general population (21% vs 8% and 17% vs 1%; P = 0.0007 and P < 0.0001, respectively), with no influence of family history. Similarly, BRCA1 patients had an increased prevalence of IPMN (8.3% vs 1%; P < 0.0001).
Conclusions
In this series, 4% and 17% of BRCA2 patients developed PDAC and IPMN, respectively. Eight percent of BRCA1 patients developed IPMN. Under current recommended screening, 60% of BRCA1/2 patients had incompletely pancreatic assessment. With no influence of family history, this study suggests all BRCA1/2 patients should undergo a high‐risk screening protocol that will identify a higher rate of precancerous pancreatic neoplasms amenable to curative resection.</description><subject>Breast cancer</subject><subject>breast cancer mutation</subject><subject>Cancer surgery</subject><subject>intraductal papillary mucinous neoplasm</subject><subject>Medical imaging</subject><subject>Mutation</subject><subject>pancreatic adenocarcinoma</subject><subject>Pancreatic cancer</subject><subject>screening</subject><subject>Tumors</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kMtKAzEUhoMotlYXvoAMuNHFtLnMZJKV1OKVQsELLkOaOZUpnaQmM0jf3tipLgQhcHL4Pz4OP0KnBA8JxnS0DG5Ic1bwPdQnWPJUYin2UT9mNM0KiXvoKIQlxlhKnh2iHsOccZyTPnobe0iunyZjkmhbbn80eQcLSd02uqmcTdZxgG1C0toSfDAeYlwmC-djZOMac5PoEqwz2pvKulpfHaODhV4FONnNAXq9vXmZ3KfT2d3DZDxNTUbioYLmUhIiTEZ5aQohBJ6z-AQVVGKBKSEZA2A5A52XBeeCas0WXBoBeSYIG6CLzrv27qOF0Ki6CgZWK23BtUFRUkhWRDuP6PkfdOlab-N1ilKcF5nkVEbqsqOMdyF4WKi1r2rtN4pg9d22im2rbduRPdsZ23kN5S_5U28ERh3wWa1g879JPT7POuUXdhWFlQ</recordid><startdate>20190501</startdate><enddate>20190501</enddate><creator>Roch, Alexandra M.</creator><creator>Schneider, Justine</creator><creator>Carr, Rosalie A.</creator><creator>Lancaster, William P.</creator><creator>House, Michael G.</creator><creator>Zyromski, Nicholas J.</creator><creator>Nakeeb, Attila</creator><creator>Schmidt, C. Max</creator><creator>Ceppa, Eugene P.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7835-3370</orcidid></search><sort><creationdate>20190501</creationdate><title>Are BRCA1 and BRCA2 gene mutation patients underscreened for pancreatic adenocarcinoma?</title><author>Roch, Alexandra M. ; Schneider, Justine ; Carr, Rosalie A. ; Lancaster, William P. ; House, Michael G. ; Zyromski, Nicholas J. ; Nakeeb, Attila ; Schmidt, C. Max ; Ceppa, Eugene P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4196-82599118c426dc78880b30b38282908021143ee353ea5d76682aa3f69c8e54813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Breast cancer</topic><topic>breast cancer mutation</topic><topic>Cancer surgery</topic><topic>intraductal papillary mucinous neoplasm</topic><topic>Medical imaging</topic><topic>Mutation</topic><topic>pancreatic adenocarcinoma</topic><topic>Pancreatic cancer</topic><topic>screening</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roch, Alexandra M.</creatorcontrib><creatorcontrib>Schneider, Justine</creatorcontrib><creatorcontrib>Carr, Rosalie A.</creatorcontrib><creatorcontrib>Lancaster, William P.</creatorcontrib><creatorcontrib>House, Michael G.</creatorcontrib><creatorcontrib>Zyromski, Nicholas J.</creatorcontrib><creatorcontrib>Nakeeb, Attila</creatorcontrib><creatorcontrib>Schmidt, C. Max</creatorcontrib><creatorcontrib>Ceppa, Eugene P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roch, Alexandra M.</au><au>Schneider, Justine</au><au>Carr, Rosalie A.</au><au>Lancaster, William P.</au><au>House, Michael G.</au><au>Zyromski, Nicholas J.</au><au>Nakeeb, Attila</au><au>Schmidt, C. Max</au><au>Ceppa, Eugene P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are BRCA1 and BRCA2 gene mutation patients underscreened for pancreatic adenocarcinoma?</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2019-05-01</date><risdate>2019</risdate><volume>119</volume><issue>6</issue><spage>777</spage><epage>783</epage><pages>777-783</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Breast cancer (BRCA) mutations account for the highest proportion of hereditary causes of pancreatic ductal adenocarcinoma (PDAC). Screening is currently recommended only for patients with one first‐degree relative or two family members with PDAC. We hypothesized that screening all BRCA1/2 patients would identify a higher rate of pancreatic abnormalities.
Methods
All BRCA1/2 patients at a single academic center were retrospectively reviewed (2005‐2015). Pancreatic abnormalities were defined on cross‐sectional imaging as pancreatic neoplasm (cystic/solid) or main‐duct dilation.
Results
Two hundred and four patients were identified with BRCA mutations. Forty‐seven (40%) had abdominal imaging (20 computerized tomography and 27 magnetic resonance imaging). Twenty‐one percent had pancreatic abnormalities (PDAC [n = 2] and intraductal papillary mucinous neoplasm [IPMN; n = 8]). The prevalence of pancreatic abnormalities and IPMN was higher in BRCA2 patients than in the general population (21% vs 8% and 17% vs 1%; P = 0.0007 and P < 0.0001, respectively), with no influence of family history. Similarly, BRCA1 patients had an increased prevalence of IPMN (8.3% vs 1%; P < 0.0001).
Conclusions
In this series, 4% and 17% of BRCA2 patients developed PDAC and IPMN, respectively. Eight percent of BRCA1 patients developed IPMN. Under current recommended screening, 60% of BRCA1/2 patients had incompletely pancreatic assessment. With no influence of family history, this study suggests all BRCA1/2 patients should undergo a high‐risk screening protocol that will identify a higher rate of precancerous pancreatic neoplasms amenable to curative resection.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30636051</pmid><doi>10.1002/jso.25376</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7835-3370</orcidid></addata></record> |
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| subjects | Breast cancer breast cancer mutation Cancer surgery intraductal papillary mucinous neoplasm Medical imaging Mutation pancreatic adenocarcinoma Pancreatic cancer screening Tumors |
| title | Are BRCA1 and BRCA2 gene mutation patients underscreened for pancreatic adenocarcinoma? |
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