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What management for the asymptomatic men carriers of BRCA1 or 2 mutation? Results of a survey in the French oncogenetic centers


Bulletin du Cancer. Volume 99, Number 4, 417-23, Avril 2012, Article original

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Author(s) : Iglika Brachot-Simeonova, Gilles Morin, Claire Gillaux, Bénédicte Demeer, Jean Gondry, Michèle Mathieu, Raffaèle Fauvet

Summary : The aim of this survey of practice was to define, in the absence of guideline, the management in France of asymptomatic men bearing a mutation of BRCA1 or 2 genes. A questionnaire was addressed to 90 oncogenetics centers. We obtained the answers of 34 practitioners working in 58 centers. Among the responders, 85.3% offered a systematic genetic test in all cases to determine the risk of transmission to the children and to offer a personal follow-up in 79.4 % of cases. This screening was directed towards prostate cancer, breast cancer and pancreatic cancer in respectively 94.1, 67.6 and 47.1% of cases. The screening of prostate cancer was mainly proposed to men bearing a BRCA2 mutation and from the age of 40 years. It was based on clinical examination and testing of prostate specific antigen. The screening of breast cancer was mainly proposed to men bearing a BRCA2 mutation and based on clinical examination and self-palpation without stating a started age. The screening of pancreatic cancer was mainly proposed to men with familial history of pancreatic cancer and from the age of 40 years. It was based on tomography and MRI. For the majority of answerers, the general practitioner was the best to perform all these screenings. These experts’ opinions can help to establish guidelines for the global management of asymptomatic men carriers of BRCA1 or 2 mutations.

Keywords : BRCA1 mutation, BRCA2 mutation, asymptomatic men carriers, survey of practice, screening, guidelines

 

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