1. Prevalence of BRCA1 and BRCA2 Mutations in Patients with Primary Ovarian Cancer – Does the German Checklist for Detecting the Risk of Hereditary Breast and Ovarian Cancer Adequately Depict the Need for Consultation?
- Author
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Rita K. Schmutzler, Alexander Traut, Kerstin Rhiem, S Ehmann, Philipp Harter, Andreas du Bois, Thaïs Baert, Stephanie Schneider, Denise Tripon, N Pauly, Helmut Plett, Beyhan Ataseven, and Florian Heitz
- Subjects
0301 basic medicine ,MAINTENANCE THERAPY ,PENETRANCE ,medicine.medical_specialty ,endocrine system diseases ,SCORING SYSTEM ,Genetic counseling ,MODELS ,Population ,hereditary breast and ovarian cancer ,GERMLINE BRCA1 ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Maternity and Midwifery ,medicine ,education ,heritability checklist ,Genetic testing ,education.field_of_study ,Science & Technology ,CARRIER PROBABILITIES ,medicine.diagnostic_test ,business.industry ,BRCA mutation ,Obstetrics & Gynecology ,WOMEN ,Obstetrics and Gynecology ,ASSOCIATION ,SERIES ,medicine.disease ,Checklist ,ovarian cancer ,030104 developmental biology ,030220 oncology & carcinogenesis ,Cohort ,Mutation (genetic algorithm) ,BOADICEA ,business ,Ovarian cancer ,Life Sciences & Biomedicine - Abstract
Background BRCA1/2 mutations are the leading cause of hereditary epithelial ovarian cancer (EOC). The German Consortium for Hereditary Breast and Ovarian Cancer has defined inclusion criteria, which are retrievable as a checklist and facilitate genetic counselling/testing for affected persons with a mutation probability of ≥ 10%. Our objective was to evaluate the prevalence of the BRCA1/2 mutation(s) based on the checklist score (CLS). Methods A retrospective data analysis was performed on EOC patients with a primary diagnosis treated between 1/2011 – 5/2019 at the Central Essen Clinics, where a BRCA1/2 genetic analysis result and a CLS was available. Out of 545 cases with a BRCA1/2 result (cohort A), 453 cases additionally had an extended gene panel result (cohort B). Results A BRCA1/2 mutation was identified in 23.3% (127/545) in cohort A, pathogenic mutations in non-BRCA1/2 genes were revealed in a further 6.2% in cohort B. In cohort A, 23.3% (127/545) of patients had a BRCA1 (n = 92) or BRCA2 (n = 35) mutation. Singular EOC (CLS 2) was present in 40.9%. The prevalence for a BRCA1/2 mutation in cohort A was 10.8%, 17.2%, 25.0%, 35.1%, 51.4% and 66.7% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively. The mutation prevalence in cohort B was 15.9%, 16.4%, 28.2%, 40.4%, 44.8% and 62.5% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively. Conclusions The BRCA1/2 mutation prevalence in EOC patients positively correlates with a rising checklist score. Already with singular EOC, the prevalence of a BRCA1/2 mutation exceeds the required 10% threshold. Our data support the recommendation of the S3 guidelines Ovarian Cancer of offering genetic testing to all patients with EOC. Optimisation of the checklist with clear identification of the testing indication in this population should therefore be aimed for.
- Published
- 2020