The Effect of BRCA Testing on Breast Cancer Treatment

BRCA testing in breast cancer patients younger than 40 increased, could affect treatment decisions

(RxWiki News) Genetic testing in younger women with breast cancer may be getting more common. And that could have an effect on those women's future treatment decisions.

That's the latest from a new study, which called for all female breast cancer patients younger than 40 to be offered BRCA1 and BRCA2 testing.

Current guidelines call for women age 50 and younger who are diagnosed with breast cancer to receive genetic testing. Mutations in the BRCA1 and 2 genes mean some women could face an increased risk of early-onset breast cancer. Knowledge of her genetic status could help a woman make treatment decisions like whether to undergo double mastectomy (removal of both breasts) to prevent future breast cancers.

The current study, led by Ann H. Partridge, MD, of the Dana Farber Cancer Institute in Boston, found that the proportion of breast cancer patients younger than 40 receiving BRCA testing has increased in recent years. In 2006, for instance, 76.9 percent of the patients in the study diagnosed with breast cancer said they underwent testing. By 2013, that figure had increased to 95.3 percent.

Testing rates might have increased as a result of increased awareness, these researchers said. Most of the 897 study patients were insured and educated.

"It is encouraging to see the integration of [genetic cancer risk assessment] into standard-of-care clinical treatment of breast cancer over the past two decades," wrote Jeffrey N. Weitzel, MD, of the City of Hope, a cancer hospital in California, and coauthors, in an editorial about this study. "The task remains to ensure that the benefits of [testing] reach more individuals and families, including those among underrepresented minorities, with economic disparities, and in low- to middle-income countries. As long as there are growing communities of practice and research collaboration, it won't take another 20 years to get there."

Among the breast cancer patients who were tested for BRCA mutations in this study, 29.8 percent said the test results influenced their treatment decisions. The majority of women who found out they carried gene mutations opted for a double mastectomy.

Around 12 percent of US women will develop breast cancer at some point, according to Treatment for breast and other cancers is a decision doctors and patients should make together.

The study and editorial were published Feb. 11 in the journalJAMA Oncology.

Susan G. Komen for the Cure, the National Institutes of Health and the Pink Agenda funded this research. Study author Dr. Judy E. Garber received funds from genetics companies and was a consultant for Pfizer and Sequenom.

Review Date: 
February 13, 2016