Emory University School of Medicine, 1462 Clifton Road, Suite 310, MS 1370-003-1AE, Atlanta, GA 30322, USA.
Obstet Gynecol Clin North Am. 2022 Mar;49(1):117-147. doi: 10.1016/j.ogc.2021.11.005.
This article provides an update on hereditary breast and ovarian cancer syndrome (HBOC) associated with pathogenic variants (PVs) in BRCA1/2. While many new genes have been identified and are included in testing panels, HBOC will serve as the primary example to illustrate the main concepts involved in genetic testing and management for hereditary breast and/or ovarian cancer We provide practical information regarding collecting a family history, cancer risk assessment, genetic testing and result interpretation, BRCA-associated cancer prognosis and treatment, screening recommendations, and prevention strategies. We also introduce implications of more recently identified cancer genes, polygenic risk scores (PRSs), and tumor genomic profiling. Evidence-based management strategies have been shown to reduce cancer incidence and improve survival in HBOC and other high penetrance syndromes. Obstetricians and gynecologists familiar with these concepts can identify and improve the quality of care for women and families impacted by hereditary breast and/or ovarian cancer.
本文介绍了与 BRCA1/2 中的致病性变异(PVs)相关的遗传性乳腺癌和卵巢癌综合征(HBOC)的最新情况。虽然已经鉴定出许多新基因并包含在检测面板中,但 HBOC 将作为主要示例来说明遗传检测和管理遗传性乳腺癌和/或卵巢癌的主要概念。我们提供了有关收集家族史、癌症风险评估、基因检测和结果解释、BRCA 相关癌症预后和治疗、筛查建议和预防策略的实用信息。我们还介绍了最近发现的癌症基因、多基因风险评分(PRSs)和肿瘤基因组分析的影响。已证明循证管理策略可降低 HBOC 和其他高外显率综合征的癌症发病率并改善生存。熟悉这些概念的妇产科医生可以识别并改善受遗传性乳腺癌和/或卵巢癌影响的女性和家庭的护理质量。