2010 Breast cancer incidence age 20-84: 37947 Rate: 165/100. 000


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  • 2010

    • Breast cancer incidence age 20-84: 37947
      • Rate: 165/100.000
    • Breast cancer incidence age 20-39: 1788 (4%)
      • Rate: 25/100.000


Baseline risk assessment

  • Baseline risk assessment

    • Prognostic factors
      • Age
      • T size
      • N
      • Histologic grade
      • HER2
      • ER (?)












Risk of hereditary breast cancer



Estimate the likelihood that BRCA1-2 mutation is present

  • Estimate the likelihood that BRCA1-2 mutation is present

  • BRCA1 (cr.17)/BRCA2 (cr.13)

    • High penetrance: 45-84% lifetime risk of BC. Increased risk of contralateral BC (up to 60%). 11-62% lifetime risk of ovarian cancer
  • BRCA1

  • Management of patients with BRCA1/2 mutations

    • Consider bilteral risk reduction mastectomy
    • Consider bilateral risk reduction salpingo-oophorectomy after completion of childbearing


Risk of hereditary breast cancer

  • Risk of hereditary breast cancer

  • Optimal endocrine treatment

  • Fertility/pregnancy issues













Risk of hereditary breast cancer

  • Risk of hereditary breast cancer

  • Optimal endocrine treatment

  • Fertility/pregnancy issues





























From March 2010 to march 2012

  • From March 2010 to march 2012

    • 28 patients <= 40 yrs treated at IST-Genoa were offered strategies for fertility/ovarian function preservation
    • Oocyte cryopreservation
      • 3/28 accepted : 11.0%
    • GnRHa temporary ovarian suppression
      • 25/28 accepted : 89.0%


IST

  • IST

  • IRCCS Giannina Gaslini

    • Dipartimento Ostetrico Neonatale
  • Ospedale S. Martino

    • Centro di Fisiopatologia della Riproduzione umana dell’UO di Clinica Ostetricia e Ginecologia.



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