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Women with triple-negative breast cancer aged younger than 50 years may benefit from BRCA testing
Kwon JS. J Clin Oncol. 2010;28:4214-4220.
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BRCA mutation testing in women aged younger than 50 years with triple-negative breast cancer was cost-effective and may help reduce risk for future cancers in these women and their families.
In a recent study, researchers estimated the costs and net health benefits of different BRCA testing criteria for women with breast cancer aged younger than 50 years.
They developed a Markov Monte Carlo simulation to compare the following six criteria for BRCA mutation testing:
- No testing.
- Women with medullary breast cancer aged younger than 50 years.
- Women with any type of breast cancer aged younger than 40 years.
- Women with triple-negative breast cancer aged younger than 40 years.
- Women with triple-negative breast cancer aged younger than 50 years.
- All women with breast cancer aged younger than 50 years.
In this model, the number of new breast and ovarian cancer cases were estimated.
Testing women with breast cancer who were aged younger than 50 years could prevent the highest number of breast and ovarian cancers, according to the researchers. The incremental cost-effectiveness ratio, however, was unfavorable at $59,503 per year of life and $112,908 quality-adjusted life year gained when compared with testing women with triple-negative breast cancer aged younger than 50 years.
Testing women with triple-negative breast cancer aged younger than 50 years had a favorable incremental cost-effectiveness ratio at $8,027 per year of life gained and $9,084 per quality-adjusted life year gained.
The researchers estimated that BRCA mutation testing in women with triple-negative breast cancer aged younger than 50 years would reduce subsequent breast cancer risk by 23% and ovarian cancer risk by 41%.
Testing for BRCA1 and BRCA2 mutations has become part of our standard practice because it can help both affected and unaffected women make decisions about screening and prevention measures, including prophylactic surgery. Studies such as that from Kwon and colleagues can help us to refine who should be offered testing so that we can target testing to those who will potentially benefit the most.
– Nancy Davidson, MD
HemOnc Today Editorial Board member