JAMA Oncol:年轻乳腺癌患者的BRCA基因突变检测逐年增多

2016-02-13 MedSci MedSci原创

 乳腺癌是美国40岁以下女性最为常见的癌症。因为BRCA1和BRCA2基因突变携带者有更高的患乳腺癌的风险,所以美国国家综合癌症网络(NCCN)指南推荐在50岁之前被诊断为乳腺癌的患者进行基因检测。但是,目前对于围绕检测相关的决策以及检测结果对这些年轻患者的治疗决策有何影响尚不得知。为了研究BRCA突变基因检测的使用和评价遗传风险的关注以及遗传信息的使用如何影响随后的乳腺癌治疗,研究人员

乳腺癌是美国40岁以下女性最为常见的癌症。因为BRCA1BRCA2基因突变携带者有更高的患乳腺癌的风险,所以美国国家综合癌症网络(NCCN)指南推荐在50岁之前被诊断为乳腺癌的患者进行基因检测。但是,目前对于围绕检测相关的决策以及检测结果对这些年轻患者的治疗决策有何影响尚不得知。为了研究BRCA突变基因检测的使用和评价遗传风险的关注以及遗传信息的使用如何影响随后的乳腺癌治疗,研究人员进行了一项横截面分析。

数据来自于多项研究,包括了the Helping Ourselves, Helping Others: Young Women’s Breast Cancer Study以及一项正在进行中的前瞻性队列研究。数据的时间范围是2006年10月10日到2014年12月31日。研究受试者包括了在11个医学中心诊断的897名年龄在四十岁及以下的乳腺癌的患者。主要结果是BRCA检测的使用频率和趋势以及遗传信息如何被用于对BRCA基因突变阴性或阳性的患者作出治疗决策。其中87.0%(780人)在乳腺癌诊断后的一年进行了BRCA检测(诊断的评价年龄为35.3岁,未做检测的女性则为36.9岁)。29.8%的患者表明有关遗传风险的知识或者担心影响手术治疗的决策。

此次研究表明,年轻乳腺癌患者的BRCA基因突变检测使用率正在逐年增加。这对今后治疗乳腺癌有着重要的指导意义。

原始出处:
Rosenberg SM, Ruddy KJ, Tamimi RM, et al. BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer. JAMA Oncol. Published online February 11, 2016. doi:10.1001/jamaoncol.2015.5941.

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    2016-10-12 minlingfeng
  4. 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createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/DC48AC6B5FFD609EED5594C15A97B420/100, createdBy=57dc2500034, createdName=ms1692212821629096, createdTime=Tue Nov 08 16:06:00 CST 2016, time=2016-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1864755, encodeId=0bcc1864e5559, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Oct 12 06:06:00 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95583, encodeId=ef4d95583ce, content=了解一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:16:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086544, encodeId=870f2086544e4, content=<a href='/topic/show?id=d6a53695ce' target=_blank style='color:#2F92EE;'>#BRCA基因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3695, encryptionId=d6a53695ce, topicName=BRCA基因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f73a255, createdName=medscijoin, createdTime=Tue Jul 19 02:06:00 CST 2016, time=2016-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64298, encodeId=2d5a6429886, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:18:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64299, encodeId=a12c64299c8, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:18:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64297, encodeId=56dd6429e71, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:17:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570981, encodeId=1e1815e098167, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593990, encodeId=f24e159399099, content=<a href='/topic/show?id=63cc368459' target=_blank style='color:#2F92EE;'>#BRCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3684, encryptionId=63cc368459, topicName=BRCA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=918e18200218, createdName=cmj14wellington, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=)]
    2016-08-02 1dd8c52fm63(暂无匿称)

    了解一下!

    0

  5. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:18:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64299, encodeId=a12c64299c8, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:18:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64297, encodeId=56dd6429e71, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:17:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570981, encodeId=1e1815e098167, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593990, encodeId=f24e159399099, content=<a href='/topic/show?id=63cc368459' target=_blank style='color:#2F92EE;'>#BRCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3684, encryptionId=63cc368459, topicName=BRCA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=918e18200218, createdName=cmj14wellington, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1769254, encodeId=fbb31e69254bf, content=<a href='/topic/show?id=e392489653e' target=_blank style='color:#2F92EE;'>#年轻乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48965, encryptionId=e392489653e, topicName=年轻乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e12138003973, createdName=bshuang, createdTime=Sun Oct 30 00:06:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992482, encodeId=82ba1992482eb, content=<a href='/topic/show?id=5d08418112d' target=_blank style='color:#2F92EE;'>#基因突变检测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41811, encryptionId=5d08418112d, topicName=基因突变检测)], attachment=null, authenticateStatus=null, 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level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Feb 15 07:17:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570981, encodeId=1e1815e098167, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593990, encodeId=f24e159399099, content=<a href='/topic/show?id=63cc368459' target=_blank style='color:#2F92EE;'>#BRCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3684, encryptionId=63cc368459, topicName=BRCA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=918e18200218, createdName=cmj14wellington, createdTime=Mon Feb 15 03:06:00 CST 2016, time=2016-02-15, status=1, ipAttribution=)]
    2016-02-15 wzf990214

    有意思

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1769254, encodeId=fbb31e69254bf, content=<a href='/topic/show?id=e392489653e' target=_blank style='color:#2F92EE;'>#年轻乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48965, encryptionId=e392489653e, topicName=年轻乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e12138003973, createdName=bshuang, createdTime=Sun Oct 30 00:06:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1992482, encodeId=82ba1992482eb, content=<a href='/topic/show?id=5d08418112d' target=_blank style='color:#2F92EE;'>#基因突变检测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41811, encryptionId=5d08418112d, topicName=基因突变检测)], attachment=null, authenticateStatus=null, 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    2016-02-15 wzf990214

    0

  8. 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    2016-02-15 wzf990214

    赞一个

    0

  9. 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  10. 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杜克大学癌症研究所的研究人员将研究结果发表在Radiology。人们认为,接受乳房活检十分令人难以接受。怀疑患有乳腺癌需要切除乳房组织的女性需要进行乳房活检,但女性进行乳房活检往往十分疼痛,并且深感焦虑。 Mary Scott Soo博士指出,若在活检过程中病人觉得痛苦和焦虑,则会降低活检的有效性,因此导致患者不会坚持随访检查和评估。 根据美国国立卫生研究院(NIH)既往研究表明,冥想可以降低血压

JCO:重组人红细胞生成素(EPO)并不优于RBC输血

 由于癌症患者接受化疗导致骨髓抑制,贫血也就成了这些癌症患者经常出现的症状。早前的研究表明促红细胞生成素刺激试剂可以减少对血红细胞输血的需求,增加血红蛋白水平,改善由化疗导致贫血的癌症患者的生活质量,也有可能延长生存时间。研究人员开展了一项随机、非盲、多中心、非劣性的临床三期试验来评价重组人红细胞生成素(EPO)用于治疗转移性乳腺癌患者化疗导致的贫血。 血红蛋白低于11.0 g

BMJ研究新闻:化疗可致乳腺癌患者更易发生感染

据发表于Breast Cancer Research的一项新的研究表明,乳腺癌患者接受化疗后更容易发生感染,主要是由于化疗损耗了患者的免疫系统,因此,某些情况下,可以考虑再接种以对抗常见的免疫原。

JCO:乳腺癌患者吸烟,死亡率更高!

 在美国,每年有数十万人过早死亡是和吸烟有关。吸烟目前仍然是最重要的公共卫生问题之一。吸烟影响激素浓度,许多研究已经发现吸烟和乳腺癌发生风险的联系或许与吸烟的时间长短相关。吸烟增加总死亡率,但是吸烟和乳腺癌预后之间的联系尚未建立起来。 研究人员分析了乳腺癌和女性寿命研究的数据,这是一项在威斯康辛、新罕布什尔和马萨诸塞州进行的一项基于人群的前瞻性观测研究,从而评价乳腺癌预后前后的

Pediatrics:大量摄入纤维素食物可降低女性乳腺癌发病风险

在美国,乳腺癌是女性最常见的第二大癌症。2015年有246000多名妇女被诊断为乳腺癌。哈佛大学公共卫生学院的Maryam Farvid博士指出,大多数探究纤维素摄入与乳腺癌风险之间联系的既往研究结果并不突出。 她指出,这些研究一般重点关注青春期和成年早期民众的饮食,因为这一时期与导致乳腺癌的若干危险因素密切相关。 为了克服研究缺陷之处,研究人员对90534名女性(护士2期健康研究的参与者)进行了

NEJM:高危人群预防性切除乳腺、卵巢,是对或是错?

本月发表在新英国医学杂志上的文章对还未患上癌症的遗传性乳腺癌和卵巢癌综合征人群的相关的问题进行了探讨。文章讨论了乳腺癌和卵巢癌最佳的风险评估、风险降低手术的实用性、这些操作的副作用、预防癌症的替代策略和决策的最佳方法。梅奥诊所的肿瘤学家Lynn Hartmann博士,也是本文作者,他说:“遗传性乳腺癌和卵巢癌综合征女性的癌症风险高于一般人群,虽然预防性切除乳腺、输卵管和卵巢,可以降低癌症风险,但切