Risk estimation as a decision-making tool for genetic analysis of the breast cancer susceptibility genes. EC Demonstration Project on Familial Breast Cancer

Dis Markers. 1999 Oct;15(1-3):53-65. doi: 10.1155/1999/238375.

Abstract

For genetic counselling of a woman on familial breast cancer, an accurate evaluation of the probability that she carries a germ-line mutation is needed to assist in making decisions about genetic-testing. We used data from eight collaborating centres comprising 618 families (346 breast cancer only, 239 breast or ovarian cancer) recruited as research families or counselled for familial breast cancer, representing a broad range of family structures. Screening was performed in affected women from 618 families for germ-line mutations in BRCA1 and in 176 families for BRCA2 mutations, using different methods including SSCP, CSGE, DGGE, FAMA and PTT analysis followed by direct sequencing. Germ-line BRCA1 mutations were detected in 132 families and BRCA2 mutations in 16 families. The probability of being a carrier of a dominant breast cancer gene was calculated for the screened individual under the established genetic model for breast cancer susceptibility, first, with parameters for age-specific penetrances for breast cancer only [7] and, second, with age-specific penetrances for ovarian cancer in addition [20]. Our results indicate that the estimated probability of carrying a dominant breast cancer gene gives a direct measure of the likelihood of detecting mutations in BRCA1 and BRCA2. For breast/ovarian cancer families, the genetic model according to Narod et al. [20] is preferable for calculating the proband's genetic risk, and gives detection rates that indicate a 50% sensitivity of the gene test. Due to the incomplete BRCA2 screening of the families, we cannot yet draw any conclusions with respect to the breast cancer only families.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • BRCA2 Protein
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / genetics*
  • Breast Neoplasms, Male / epidemiology
  • Breast Neoplasms, Male / genetics
  • DNA Mutational Analysis* / methods
  • Decision Making*
  • Decision Support Techniques*
  • Europe / epidemiology
  • Female
  • Genes, BRCA1
  • Genes, Dominant
  • Genetic Counseling / methods*
  • Genetic Predisposition to Disease
  • Genetic Testing*
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Models, Genetic
  • Neoplasm Proteins / genetics
  • Neoplastic Syndromes, Hereditary / epidemiology
  • Neoplastic Syndromes, Hereditary / genetics*
  • Oncogenes*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / genetics
  • Predictive Value of Tests
  • Probability
  • Risk
  • Risk Assessment
  • Sensitivity and Specificity
  • Transcription Factors / genetics

Substances

  • BRCA2 Protein
  • Neoplasm Proteins
  • Transcription Factors