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Walker R, Louis A, Berlin A, et al. Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic. Can Urol Assoc J. 2014;8(11):E783-8doi: 10.5489/cuaj.1970.
Walker, R., Louis, A., Berlin, A., Horsburgh, S., Bristow, R. G., & Trachtenberg, J. (2014). Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic. Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 8(11), E783-8. https://doi.org/10.5489/cuaj.1970
Walker, Richard, et al. "Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic." Canadian Urological Association journal = Journal de l'Association des urologues du Canada vol. 8,11 (2014): E783-8. doi: https://doi.org/10.5489/cuaj.1970
Walker R, Louis A, Berlin A, Horsburgh S, Bristow RG, Trachtenberg J. Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic. Can Urol Assoc J. 2014 Nov;8(11):E783-8. doi: 10.5489/cuaj.1970. PMID: 25485004; PMCID: PMC4250241.
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Can Urol Assoc J. 2014 Nov;8(11):E783-8. doi: 10.5489/cuaj.1970.

Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

Richard Walker, Alyssa Louis, Alejandro Berlin, Sheri Horsburgh, Robert G Bristow, John Trachtenberg

Affiliations

  1. Department of Surgical Oncology, University Health Network, Toronto, ON;
  2. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON.

PMID: 25485004 PMCID: PMC4250241 DOI: 10.5489/cuaj.1970

Abstract

INTRODUCTION: The prostate-specific antigen (PSA) era and resultant early detection of prostate cancer has presented clinicians with the challenge of distinguishing indolent from aggressive tumours. Mutations in the BRCA1/2 genes have been associated with prostate cancer risk and prognosis. We describe the prostate cancer screening characteristics of BRCA1/2 mutation carriers, who may be classified as genetically-defined high risk, as compared to another high-risk cohort of men with a family history of prostate cancer to evaluate the utility of a targeted screening approach for these men.

METHODS: We reviewed patient demographics, clinical screening characteristics, pathological features, and treatment outcomes between a group of BRCA1 or BRCA2 mutation carriers and age-matched men with a family history of prostate cancer followed at our institutional Prostate Cancer Prevention Clinic from 1995 to 2012.

RESULTS: Screening characteristics were similar between the mutation carriers (n = 53) and the family history group (n = 53). Some cancers would be missed in both groups by using a PSA cut-off of >4 ug/L. While cancer detection was higher in the family history group (21% vs. 15%), the mutation carrier group was more likely to have intermediate- or high-risk disease (88% vs. 36%). BRCA2 mutation carriers were more likely to have aggressive disease, biological recurrence, and distant metastasis.

CONCLUSIONS: In our cohort, regular screening appears justified for detecting prostate cancer in BRCA1 and BRCA2 carriers and other high-risk populations. Lowering PSA cut-offs and defining monitoring of PSA velocity as part of the screening protocol may be useful. BRCA2 is associated with more aggressive disease, while the outcome for BRCA1 mutation carriers requires further study. Large multinational studies will be important to define screening techniques for this unique high-risk population.

References

  1. J Natl Cancer Inst. 2002 Sep 18;94(18):1358-65 - PubMed
  2. Urology. 2002 Nov;60(5):826-30 - PubMed
  3. Am Soc Clin Oncol Educ Book. 2013;:null - PubMed
  4. Eur Urol. 2014 Sep;66(3):489-99 - PubMed
  5. J Natl Cancer Inst. 1999 Aug 4;91(15):1310-6 - PubMed
  6. N Engl J Med. 1997 May 15;336(20):1401-8 - PubMed
  7. Eur Urol. 2009 Oct;56(4):584-91 - PubMed
  8. Br J Cancer. 2012 May 8;106(10):1697-701 - PubMed
  9. Ann Intern Med. 2012 Jul 17;157(2):120-34 - PubMed
  10. Am J Hum Genet. 1999 Sep;65(3):921-4 - PubMed
  11. Br J Cancer. 2010 Sep 7;103(6):918-24 - PubMed
  12. Curr Oncol. 2010 Sep;17 Suppl 2:S11-7 - PubMed
  13. PLoS One. 2011;6(10):e27130 - PubMed
  14. Br J Cancer. 2008 Jan 29;98 (2):502-7 - PubMed
  15. J Clin Oncol. 2004 Feb 15;22(4):735-42 - PubMed
  16. Nat Genet. 2013 Apr;45(4):385-91, 391e1-2 - PubMed
  17. Clin Cancer Res. 2010 Apr 1;16(7):2115-21 - PubMed
  18. N Engl J Med. 2012 Jul 19;367(3):203-13 - PubMed
  19. J Med Genet. 2003 Oct;40(10):787-92 - PubMed
  20. Cancer Prev Res (Phila). 2011 Jul;4(7):1002-10 - PubMed
  21. N Engl J Med. 2009 Mar 26;360(13):1320-8 - PubMed
  22. J Natl Cancer Inst. 2007 Jun 20;99(12):929-35 - PubMed
  23. J Clin Oncol. 2013 May 10;31(14):1748-57 - PubMed
  24. Prostate. 2005 Oct 1;65(2):124-9 - PubMed
  25. JAMA. 1998 Sep 16;280(11):969-74 - PubMed

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