Evaluating high-risk breast cancer surveillance outcomes in BRCA mutation carriers.
[BACKGROUND] Long-term outcome on breast cancer surveillance in BRCA mutation carriers are limited, especially in Asian populations where uptake of preventive surgery is low.
- 추적기간 39.1 months
- 연구 설계 cohort study
APA
Chang YK, Luk WP, et al. (2026). Evaluating high-risk breast cancer surveillance outcomes in BRCA mutation carriers.. Breast cancer (Tokyo, Japan), 33(2), 407-414. https://doi.org/10.1007/s12282-026-01822-x
MLA
Chang YK, et al.. "Evaluating high-risk breast cancer surveillance outcomes in BRCA mutation carriers.." Breast cancer (Tokyo, Japan), vol. 33, no. 2, 2026, pp. 407-414.
PMID
41632395
Abstract
[BACKGROUND] Long-term outcome on breast cancer surveillance in BRCA mutation carriers are limited, especially in Asian populations where uptake of preventive surgery is low.
[METHODS] We conducted a retrospective cohort study of 722 female and mutation carriers enrolled between January 2007 and December 2024 in the Hong Kong Hereditary Breast Cancer Family Registry. Of these, 702 (97.2%) underwent structured high-risk surveillance comprising biannual clinical breast examination and alternating 6-monthly breast magnetic resonance imaging and mammography or digital breast tomosynthesis with ultrasonography. The outcomes were breast cancer detection rate, stage, nodal status, interval cancer occurrence, and breast cancer–specific mortality.
[RESULTS] Risk-reducing mastectomy was undertaken by 90 out of 722 carriers (12.5%). Surveillance detected 64 breast cancers during 4,398 imaging sessions (detection rate 1.5%). Most cancers (89.1%) were diagnosed at stage 0 or I, and 95.3% were node- negative. Interval cancers were uncommon. Among 304 carriers initially free of breast cancer who later developed the disease ( = 26), no breast cancer–specific death occurred. Overall, breast cancer–specific mortality in the cohort was 2.4%, with most deaths due to ovarian cancer with a median follow-up of 39.1 months (range, 6-212.3). Longer term follow-up is warranted.
[CONCLUSIONS] In this first Asian surveillance cohort of BRCA mutation carriers, prophylactic mastectomy uptake was low, yet structured screening enabled early-stage detection and minimal interval cancer. Surveillance should be considered as a key management strategy, with preventive surgery options individualized and cost-effectiveness evaluated.
[METHODS] We conducted a retrospective cohort study of 722 female and mutation carriers enrolled between January 2007 and December 2024 in the Hong Kong Hereditary Breast Cancer Family Registry. Of these, 702 (97.2%) underwent structured high-risk surveillance comprising biannual clinical breast examination and alternating 6-monthly breast magnetic resonance imaging and mammography or digital breast tomosynthesis with ultrasonography. The outcomes were breast cancer detection rate, stage, nodal status, interval cancer occurrence, and breast cancer–specific mortality.
[RESULTS] Risk-reducing mastectomy was undertaken by 90 out of 722 carriers (12.5%). Surveillance detected 64 breast cancers during 4,398 imaging sessions (detection rate 1.5%). Most cancers (89.1%) were diagnosed at stage 0 or I, and 95.3% were node- negative. Interval cancers were uncommon. Among 304 carriers initially free of breast cancer who later developed the disease ( = 26), no breast cancer–specific death occurred. Overall, breast cancer–specific mortality in the cohort was 2.4%, with most deaths due to ovarian cancer with a median follow-up of 39.1 months (range, 6-212.3). Longer term follow-up is warranted.
[CONCLUSIONS] In this first Asian surveillance cohort of BRCA mutation carriers, prophylactic mastectomy uptake was low, yet structured screening enabled early-stage detection and minimal interval cancer. Surveillance should be considered as a key management strategy, with preventive surgery options individualized and cost-effectiveness evaluated.