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Model Compares Impact of Breast Cancer Mutations

Related study shows mutations to be associated with a lower response to fertility treatment

WEDNESDAY, Dec. 9 (HealthDay News) -- A computer model can help compare the impact of various treatment strategies on survival in women with mutations in the BRCA genes that increase the risk of breast cancer, according to a study published online Dec. 7 in the Journal of Clinical Oncology. In a related study published at the same time in the same journal, researchers report that BRCA mutations are associated with lower responses to fertility treatment.

Allison W. Kurian, M.D., and colleagues from the Stanford University School of Medicine in California developed a Monte Carlo computer simulation to analyze the impact of screening and treatment on outcomes in women with BRCA1 or BRCA2 mutations. They found that mammography screening plus magnetic resonance imaging appeared to give similar survival as prophylactic mastectomy at 25 years of age plus prophylactic oophorectomy at 40 years of age.

Kutluk Oktay, M.D., from New York Medical College in Valhalla, and colleagues examined whether having BRCA mutations affected the response to fertility treatment in 12 women with clinically-significant BRCA mutations and 33 women without mutations. They found that significantly more women with mutations had a low response to fertility treatment (33.3 versus 3.3 percent). The low response rate was entirely due to BRCA1 mutations (odds ratio, 38.3 compared with BRCA2 mutations), which were also associated with lower egg production than BRCA2 mutations.

"The results of this study have the potential to markedly facilitate decision making as women can be provided with BRCA mutation-specific data on the effects of different risk management strategies, undertaken at varying ages, on overall survival as well as on survival from breast and gynecologic cancer," write the authors of an accompanying editorial.

Authors of the editorial reported financial relationships with the pharmaceutical industry.

Abstract - Kurian
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Abstract - Oktay
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