Abstract
No study has evaluated the performance of BRCA1/2 mutations prediction models in male breast cancer (MBC) series. Although rare, MBC deserves attention because male and female breast cancers share many characteristics, including the involvement of genetic predisposition factors such as BRCA1/BRCA2 mutations. Indeed, the occurrence of MBC is a commonly used criterion to select families for BRCA mutation testing. We evaluated the performance and clinical effectiveness of four different predictive models in a population-based series of 102 Italian MBC patients characterized for BRCA1/2 mutations. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for each risk model at the 10% threshold. The area under the ROC (AUC) curves and its corresponding asymptotic 95% CIs were calculated as a measure of the accuracy. In our study, the BRCAPRO version 5.0 had the highest combination of sensitivity, specificity, NPV and PPV for the combined probability and for the discrimination of BRCA2 mutations. In individuals with negative breast–ovarian cancer family history, BRCAPRO 5.0 reached a high discriminatory capacity (AUC=0.92) in predicting BRCA2 mutations and showed values of sensitivity, specificity, NPV and PPV of 0.5, 0.98, 0.97 and 0.67, respectively, for the combined probability. BRCAPRO version 5.0 can be particularly useful in dealing with non-familial MBC, a circumstance that often represents a challenging situation in genetic counseling.
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References
Frank TS, Deffenbaugh AM, Reid JE et al: Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10 000 individuals. J Clin Oncol 2002; 20: 1480–1490.
Gilpin CA, Carson N, Hunter AG : A preliminary validation of a family history assessment form to select women at risk for breast or ovarian cancer for referral to a genetics center. Clin Genet 2000; 58: 299–308.
Parmigiani G, Berry D, Aguilar O : Determining carrier probabilities for breast cancer-susceptibility genes BRCA1 and BRCA2. Am J Hum Genet 1998; 62: 145–158.
Berry DA, Iversen Jr ES, Gudbjartsson DF et al: BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes. J Clin Oncol 2002; 20: 2701–2712.
Marroni F, Aretini P, D’Andrea E et al: Penetrances of breast and ovarian cancer in a large series of families tested for BRCA1/2 mutations. Eur J Hum Genet 2004; 12: 899–906.
Capalbo C, Ricevuto E, Vestri A et al: Improving the accuracy of BRCA1/2 mutation prediction: validation of the novel country-customized IC software. Eur J Hum Genet 2006; 14: 49–54.
Barcenas CH, Hosain GM, Arun B et al: Assessing BRCA carrier probabilities in extended families. J Clin Oncol 2006; 24: 354–360.
Antoniou AC, Durocher F, Smith P, Simard J, Easton DF : BRCA1 and BRCA2 mutation predictions using the BOADICEA and BRCAPRO models and penetrance estimation in high-risk French-Canadian families. Breast Cancer Res 2006; 8: R3.
Panchal SM, Ennis M, Canon S, Bordeleau LJ : Selecting a BRCA risk assessment model for use in a familial cancer clinic. BMC Med Genet 2008; 9: 116.
Kurian AW, Gong GD, Chun NM et al: Performance of BRCA1/2 mutation prediction models in Asian Americans. J Clin Oncol 2008; 26: 4752–4758.
Kurian AW, Gong GD, John EM et al: Performance of prediction models for BRCA mutation carriage in three racial/ethnic groups: findings from the Northern California Breast Cancer Family Registry. Cancer Epidemiol Biomarkers Prev 2009; 18: 1084–1091.
Chen S, Blackford AL, Parmigiani G : Tailoring BRCAPRO to Asian-Americans. J Clin Oncol 2009; 27: 642–643; author reply 643–644.
Pasanisi P, Hedelin G, Berrino J et al: Oral contraceptive use and BRCA penetrance: a case-only study. Cancer Epidemiol Biomarkers Prev 2009; 18: 2107–2113.
Brinton LA, Richesson DA, Gierach GL et al: Prospective evaluation of risk factors for male breast cancer. J Natl Cancer Inst 2008; 100: 1477–1481.
Ottini L, Palli D, Rizzo S, Federico M, Bazan V, Russo A : Male breast cancer. Crit Rev Oncol Hematol 2010; 73: 141–155.
Ottini L, Rizzolo P, Zanna I et al: BRCA1/BRCA2 mutation status and clinical-pathologic features of 108 male breast cancer cases from Tuscany: a population-based study in central Italy. Breast Cancer Res Treat 2009; 116: 577–586.
Falchetti M, Lupi R, Rizzolo P et al: BRCA1/BRCA2 rearrangements and CHEK2 common mutations are infrequent in Italian male breast cancer cases. Breast Cancer Res Treat 2008; 110: 161–167.
Papi L, Putignano AL, Congregati C et al: Founder mutations account for the majority of BRCA1-attributable hereditary breast/ovarian cancer cases in a population from Tuscany, Central Italy. Breast Cancer Res Treat 2009; 117: 497–504.
Chen S, Wang W, Broman KW et al: BayesMendel: an R Environment for Mendelian risk prediction. Stat Appl Genet Mol Biol 2004; 3: 1–16.
Chen S, Parmigiani G : Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol 2007; 25: 1329–1333.
Tai YC, Domchek S, Parmigiani G, Chen S : Breast cancer risk among male BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst 2007; 99: 1811–1814.
Parmigiani G, Chen S, Iversen Jr ES et al: Validity of models for predicting BRCA 1 and BRCA2 mutations. Ann Intern Med 2007; 147: 441–450.
Kang HH, Williams R, Leary J, Ringland C, Kirk J, Ward R : Evaluation of models to predict BRCA germline mutations. Br J Cancer 2006; 95: 914–920.
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This study was supported by Regione Toscana in the frame of the High-Risk Cancer Family Project and by a grant from Associazione Italiana per la Ricerca sul Cancro (AIRC).
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Zanna, I., Rizzolo, P., Sera, F. et al. The BRCAPRO 5.0 model is a useful tool in genetic counseling and clinical management of male breast cancer cases. Eur J Hum Genet 18, 856–858 (2010). https://doi.org/10.1038/ejhg.2010.29
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DOI: https://doi.org/10.1038/ejhg.2010.29
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