BRCA1 (Phospho-Ser1423) ELISA Kit

Purpose: To develop a summary of recommendations regarding locoregional management of patients with breast cancer and germline mutations in breast cancer susceptibility genes based on the American Society of Clinical Oncology/American Society for Radiation Oncology/Society of Surgical Oncology Guideline on Management of Hereditary Breast Cancer. Methods: The American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology convened an expert panel to develop recommendations based on a systematic review of the literature and a formal consensus process. A total of 58 articles met the eligibility criteria and formed the evidentiary basis for the locoregional therapy recommendations. Additionally, 6 randomized controlled trials of systemic therapy also met eligibility criteria. Results: A joint evidence-based guideline was developed by a multidisciplinary panel, which has been separately published. From this guideline, the radiation-oncologist authors of the panel extracted pertinent surgical and radiation-specific recommendations of findings that are hereby presented. Conclusions: Patients with newly diagnosed breast cancer and BRCA1/2 mutations may be considered for breast conserving therapy (BCT), expecting similar rates of local control of the index cancer as noncarriers. The significant risk of contralateral breast cancer in these women (especially younger women), coupled with the higher risk of new cancers in the ipsilateral breast, warrant discussion of bilateral mastectomy. For women with mutations in BRCA1/2 or moderate-penetrance genes who are eligible for mastectomy, nipplesparing mastectomy is a reasonable approach. There is no evidence of increased toxicity or contralateral breast cancer events from radiation exposure in BRCA1/2 carriers. Patients with mutations in moderate-risk genes should be offered BCT as one choice after appropriate counseling. Radiation therapy should not be withheld in ATM carriers if BCT is planned. For patients with germline TP53 mutations, mastectomy is advised and radiation therapy is contraindicated except for those with a significant risk of locoregional recurrence. (C) 2020 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Background While population-based breast screening is a well-documented health strategy worldwide, very few centres offer breast-screening programmes specifically targeted at women at high risk of hereditary breast cancer. We present our experience with multimodality breast screening in a high-risk population. Methods The outcomes from a familial breast cancer clinic at the North Brisbane BreastScreen Queensland Service providing a multimodality screening programme for high-risk women were reviewed from the prospectively maintained database between 2011 and 2018. Results Over the 8 years of study period, a total of 6686 annual screening rounds were performed for 823 asymptomatic women at high risk of hereditary breast cancer. As a result, 40 cancers were diagnosed including 25 invasive ductal cancers, three invasive lobular cancers, two invasive cancers with mixed ductal and lobular features and 10 ductal carcinomasin situ. Ultrasound and mammography detected 72.5% (29/40) and 55% (22/40) of the cancers, respectively. A total of 3672 magnetic resonance imaging studies were performed. Ten (25%) cancers were initially only seen on magnetic resonance imaging including seven invasive ductal cancers, one invasive lobular cancer and two high-grade ductal carcinomasin situ. The cancer detection rate for first-round screening was 13.3 cancers per 1000 women screened, with 4.9 cancers per 1000 women detected on subsequent-round screening. One interval cancer occurred in the study period. Conclusion Multimodality breast screening of younger women at high risk of hereditary breast cancer is effective with the yield substantially exceeding the results from established breast screening programmes in older women. Co-location of this service within BreastScreen Australia efficiently shares resources.