The risk of endocrine interventions in carriers of a genetic predisposition for breast and gynecologic cancers: recommendations of the German Consortium for Hereditary Breast and Ovarian Cancer

IF 2.7 3区医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2024-09-11 DOI:10.1007/s00432-024-05936-7

O. Ortmann, S. Schüler-Toprak, K. Kast

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Abstract

Purpose

To support doctors in counselling women with genetic predisposition for breast or gynecologic cancers on endocrine interventions.

Methods

Evidence on the safety of endocrine interventions for fertility treatment, contraception, hormone replacement therapy after risk-reducing salpingo-oophorectomy (RRSO) or treatment of symptoms during peri- and postmenopause was analysed for carriers of probably pathogenic and pathogenic variants in BRCA1 or BRCA2 (BRCA1/2-pV), in other breast and ovarian cancer genes and the Lynch Syndrome. Cancer risks were compared with data on risks for the general population.

Results

Data on risk modulation of endocrine interventions in women with genetic predisposition is limited. Ovarian hyperstimulation for fertility treatment may be performed. Oral contraceptives should not be used to reduce ovarian cancer risk in BRCA1/2-pV carriers. Premenopausal BRCA1/2-pV carriers and carriers of pV in Lynch Syndrome genes should be offered hormone replacement therapy (HRT) after RRSO, to prevent diseases caused by estrogen deficiency.

Conclusion

Effect direction and strength of risk modulation by endocrine interventions is similar to the general population. Participation of individuals at risk in prospective registries is recommended.

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乳腺癌和妇科癌症遗传易感性携带者接受内分泌干预的风险：德国遗传性乳腺癌和卵巢癌联合会的建议

目的帮助医生向有乳腺癌或妇科癌症遗传倾向的妇女提供有关内分泌干预的咨询。方法分析了 BRCA1 或 BRCA2（BRCA1/2-pV）、其他乳腺癌和卵巢癌基因以及林奇综合征中可能致病和致病变异的携带者在生育治疗、避孕、降低风险的输卵管切除术（RRSO）后的激素替代疗法或围绝经期和绝经后症状治疗中进行内分泌干预的安全性证据。癌症风险与普通人群的风险数据进行了比较。可为生育治疗进行卵巢过度刺激。不应使用口服避孕药来降低 BRCA1/2-pV 携带者患卵巢癌的风险。绝经前 BRCA1/2-pV 携带者和林奇综合征基因 pV 携带者在 RRSO 后应接受激素替代疗法（HRT），以预防雌激素缺乏引起的疾病。建议高危人群参与前瞻性登记。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.