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Data on genetic anticipation in breast cancer are sparse. We sought to evaluate age at diagnosis of breast cancer in daughters with a BRCA mutation and their mothers. A review of all carriers of the BRCA mutation diagnosed with breast cancer at the Genetics Institute of a tertiary medical center in 2000-2013 yielded 80 women who could be paired with a mother with breast cancer who was either a carrier of the BRCA mutation or an obligate carrier according to pedigree analysis. Age at diagnosis, type of mutation (BRCA1, BRCA2), year of birth, and ethnicity were recorded. Paired t-test was used to analyze differences in age at cancer diagnosis between groups and subgroups. Mean age at diagnosis of breast cancer was 50.74 years (range 22-88) in the mothers and 43.85 years (range 24-75) in the daughters. The difference was statistically significant (p < 0.001). These findings were consistent regardless of type of BRCA mutation, ethnicity, or mother's year of birth. However, on separate analysis of pairs in which the mother was diagnosed before the age of 50 years, there was no significant difference in mean age at diagnosis between mothers and daughters (~42 years for both). Daughters who carry a BRCA mutation are diagnosed with breast cancer at an earlier age than their carrier mothers, with the exception of pairs in which the mother was diagnosed before the age of 50 years. Future breast-screening guidelines may need to target specific subpopulations of BRCA mutation carriers., (© 2016 Wiley Periodicals, Inc.)

Background: The number of older cancer patients has increased in recent years. Guidelines for their care are often lacking. Data on the natural course of breast cancer and outcome of therapy in this population are needed., Methods: The authors undertook a retrospective chart review with complete follow-up of 135 women diagnosed with localized breast cancer at age 80 years or older, who received standard or less than standard local treatment in 2 tertiary centers in Israel between 1991 and 2001., Results: Median age at diagnosis was 83 years. In 60 (44%) patients, initial local treatment consisted of modified radical mastectomy or lumpectomy and axillary dissection followed by radiation therapy [standard local treatment (SLT)]; 75 (56%) patients received less than SLT. Tumors were stage T1-T2 in 90% of cases, 76% of the tumors were hormone-sensitive. Infiltrating duct carcinoma predominated (90 cases), mostly (80 of 90) Grade 2-3. Lymph node metastases were detected in 32 of 73 (44%) patients who underwent axillary lymph node dissection. At a median of 70 months after diagnosis, 18 (13%) patients had disease recurrence, and 34 (25%) had died. Axillary failures were detected only in the less-than-SLT group. This did not indicate worse overall or disease-specific survival., Conclusion: Most breast cancer octogenarians in this series lived > 6 years after diagnosis. These data do not support the assumption that breast tumors are histologically more indolent in elderly patients. Less than SLT can be applied to this patient group with somewhat increased axillary failure rates that may be addressed upfront by the sentinel node technique., (2006 American Cancer Society)

Background: This prospective trial examined the feasibility, toxicity, and effectiveness of early locoregional radiotherapy after high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk American Joint Committee on Cancer (AJCC) Stage II-III and locally advanced breast carcinoma., Methods: One hundred forty-seven consecutive patients with high-risk and locally advanced breast carcinoma were included in the current study. All patients received induction chemotherapy with a doxorubicin-based therapy, which was consolidated with high-dose cyclophosphamide, carboplatin, and thiotepa followed by autologous stem cell support. Within 50 days of the transplant, the patients were treated with locoregional radiotherapy that included the chest wall or breast, the axilla and supraclavicular area, and the internal mammary chain. The volume of lung included in the treatment volume was kept to a minimum. The central lung distance of the tangential fields ranged from 0.6-2.0 cm (mean, 1.1 cm). Tamoxifen was given based on receptor status., Results: One hundred forty-six of 147 patients received the planned treatment. Only six patients had a delay in the initiation of radiotherapy, and another 16 patients had delays during radiotherapy. Leukocyte and platelet toxicities during radiotherapy were not life-threatening and blood counts thereafter returned to normal. Grade 2 (according to National Cancer Institute Common Toxicity Criteria) skin toxicity occurred in 22% of patients and Grade 3 skin toxicity occurred in 6% of patients. Radiation pneumonitis was reported to occur in 5 patients (< 4%). After a median follow-up of 36 months from diagnosis (range, 6-64 months), there were no long-term organ toxicity and no secondary malignancy reported. No treatment-related deaths were reported. Three patients (< 3%) developed locoregional recurrence., Conclusions: Locoregional radiotherapy after high-dose chemotherapy and autologous stem cell transplantation appears to be feasible and can be delivered safely within 10 weeks of transplantation. The short-term and long-term toxicity are reported to be low, with good local control., (Copyright 2001 American Cancer Society.)

Background: The optimal management of patients with ovarian carcinoma who are in complete clinical remission after completion of postoperative cisplatin-based chemotherapy has not been established., Methods: In this study, the outcomes of two groups of such patients were compared. One group of 25 patients underwent a second-look laparotomy and subsequently received three courses of intraperitoneal chemotherapy (IP group). The other group of 12 patients was not reexplored and received no additional treatment (NT group)., Results: A trend for better survival in the IP group was found compared with the NT group. There was no difference in the duration of the progression-free interval., Conclusions: More effective treatment for the consolidation of complete clinical remission in patients with ovarian carcinoma is needed.