con enfermedad oncológica relacionada, 3 tenían
ganglios axilares positivos, 2 eran pacientes con
tumores luminales.
1 era her2 positivo.
De los pacientes con mutaciones positivas con
cáncer de ovario, ambas pacientes tenían más de
65 años, tumores serosos y ninguna tenía
antecedentes familiares de cáncer.
Conclusiones
Podemos concluir que la población estudiada en
nuestra serie, coincide con los factores de riesgo
para screening de mutaciones BRCA según NCCN
en cuanto a: edad menor de 50 años, factores de
riesgo heredofamiliares, la variedad de los tumores
de mama, el tipo histológico de los tumores de
ovario.
Introduction
About 10 to 20% of women with breast cancer
have one or more first degree relatives who are also
affected by breast cancer
1,2.
Although only 5 to
10% of women not selected with breast cancer
have a hereditary form, associated with a mutated
gene, deficient in their function, up to 20% of
women with a family history of breast cancer have
a mutation in a predisposition gene for cancer of
moderate or high penetrance
3
. Primary objective:
To describe the personal and family oncological
history of patients who were asked to study BRCA
1 and BRCA 2 mutations and compare them with
the criteria used in national (INC) and international
(NCCN) guidelines Design: Retrospective,
descriptive and observational study. Population:
All the clinical histories of the patients who have
undergone the genetic counseling process and the
study for BRCA 1 and 2 mutations from July 2015
to July 2018, at the Reina Fabiola University
Clinic and Oulton, will be analyzed.
Results
The study was requested for deleterious mutations
of BRCA 1 and 2 genes in 94 individuals.
The average age was 45 years. Of the 94
individuals, 61 had breast cancer (64.89%), 10
ovarian cancer (10.63%), and 23 (24%) had no
cancer.
Of the total number of individuals, 30 were not
carried out for different reasons: 13 (43%) for
personal reasons, 3 (10%) for lack of social work
coverage, 14 (46%) did not return to consultation
All but two patients who were asked to study
BRCA 1 and 2 mutations met the criteria of the
American and national guidelines for mutation
testing.
Of the 64 individuals who performed the test, 14
(21.87%) had deleterious mutations, 1 of uncertain
significance, and 49 were negative (76.5%).
Of the 61 patients with breast cancer studied, 48
(78%) were younger than 50 years old, 24 (39.3%)
had triple negative tumors, 19 (31%) positive
axillary lymph nodes, 13 (21%) luminal tumors, 31
(50%) family history of cancer related to BRCA 1
and 2 mutations, 2 of them (3%) were of
Ashkenazi Jewish origin.
Within the 14 patients with BRCA mutations, 10
(71%) had a BRCA 1 and 4 (28%) mutation in the
BRCA 2 gene. Of these, 8 (57%) had breast cancer,
2 (14%) cancer ovary, 4 (28%) did not have cancer.
Of the 8 patients with BRCA mutated with breast
cancer: all were younger than 50 years
3 had triple negative tumors, none had relatives
with related oncological disease, 3 had positive
axillary nodes, 2 were patients with luminal tumors
1 was her2 positive.
Of the patients with positive mutations with
ovarian cancer, both patients were over 65 years
old, had serous tumors and none had a family
history of cancer.
Conclusions
We can conclude that the population studied in our
series coincides with the risk factors for screening
BRCA mutations according to NCCN in terms of:
age under 50 years, heredity-familial risk factors,
the variety of breast tumors, the histological type
of Ovarian tumors.
Bibliografía
1. Grupo Colaborativo sobre Factores
Hormonales en el Cáncer de Mama. Cáncer de
mama familiar: reanálisis colaborativo de
datos individuales de 52 estudios
epidemiológicos que incluyeron a 58,209
mujeres con cáncer de mama y 101,986
mujeres sin la enfermedad. Lancet 2001; 358:
1389.
2. Slattery ML, Kerber RA. Una evaluación
exhaustiva de los antecedentes familiares y el
riesgo de cáncer de mama. La base de datos de
población de Utah. JAMA 1993; 270: 1563.
3. Couch FJ, Nathanson KL, Offit K. Dos
décadas después de BRCA: establecer
paradigmas en la atención y prevención
personalizada del cáncer. Science 2014; 343:
1466.