@article{RhiemEngelGraeseretal.2012,
  author    = {Rhiem, Kerstin and Engel, Christoph and Graeser, Monika and Zachariae, Silke and Kast, Karin and Kiechle, Marion and Ditsch, Nina and Janni, Wolfgang and Mundhenke, Christoph and Golatta, Michael and Varga, Dominic and Preisler-Adams, Sabine and Heinrich, Tilman and Bick, Ulrich and Gadzicki, Dorothea and Briest, Susanne and Meindl, Alfons and Schmutzler, Rita K.},
  title     = {The risk of contralateral breast cancer in patients from BRCA1/2 negative high risk families as compared to patients from BRCA1 or BRCA2 positive families: a retrospective cohort study},
  series = {Breast Cancer Research},
  volume    = {14},
  journal   = {Breast Cancer Research},
  number    = {6},
  doi       = {10.1186/bcr3369},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135715},
  year      = {2012},
  abstract  = {Introduction: While it has been reported that the risk of contralateral breast cancer in patients from BRCA1 or BRCA2 positive families is elevated, little is known about contralateral breast cancer risk in patients from high risk families that tested negative for BRCA1/2 mutations. Methods: A retrospective, multicenter cohort study was performed from 1996 to 2011 and comprised 6,235 women with unilateral breast cancer from 6,230 high risk families that had tested positive for BRCA1 (n = 1,154) or BRCA2 (n = 575) mutations or tested negative (n = 4,501). Cumulative contralateral breast cancer risks were calculated using the Kaplan-Meier product-limit method and were compared between groups using the log-rank test. Cox regression analysis was applied to assess the impact of the age at first breast cancer and the familial history stratified by mutation status. Results: The cumulative risk of contralateral breast cancer 25 years after first breast cancer was 44.1\% (95\%CI, 37.6\% to 50.6\%) for patients from BRCA1 positive families, 33.5\% (95\%CI, 22.4\% to 44.7\%) for patients from BRCA2 positive families and 17.2\% (95\%CI, 14.5\% to 19.9\%) for patients from families that tested negative for BRCA1/2 mutations. Younger age at first breast cancer was associated with a higher risk of contralateral breast cancer. For women who had their first breast cancer before the age of 40 years, the cumulative risk of contralateral breast cancer after 25 years was 55.1\% for BRCA1, 38.4\% for BRCA2, and 28.4\% for patients from BRCA1/2 negative families. If the first breast cancer was diagnosed at the age of 50 or later, 25-year cumulative risks were 21.6\% for BRCA1, 15.5\% for BRCA2, and 12.9\% for BRCA1/2 negative families. Conclusions: Contralateral breast cancer risk in patients from high risk families that tested negative for BRCA1/2 mutations is similar to the risk in patients with sporadic breast cancer. Thus, the mutation status should guide decision making for contralateral mastectomy.},
  language  = {en}
}
@article{EngelRhiemHahnenetal.2018,
  author    = {Engel, Christoph and Rhiem, Kerstin and Hahnen, Eric and Loibl, Sibylle and Weber, Karsten E. and Seiler, Sabine and Zachariae, Silke and Hauke, Jan and Wappenschmidt, Barbara and Waha, Anke and Bl{\"u}mcke, Britta and Kiechle, Marion and Meindl, Alfons and Niederacher, Dieter and Bartram, Claus R. and Speiser, Dorothee and Schlegelberger, Brigitte and Arnold, Norbert and Wieacker, Peter and Leinert, Elena and Gehrig, Andrea and Briest, Susanne and Kast, Karin and Riess, Olaf and Emons, G{\"u}nter and Weber, Bernhard H. F. and Engel, Jutta and Schmutzler, Rita K.},
  title     = {Prevalence of pathogenic BRCA1/2 germline mutations among 802 women with unilateral triple-negative breast cancer without family cancer history},
  series = {BMC Cancer},
  volume    = {18},
  journal   = {BMC Cancer},
  organization    = {German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC)},
  doi       = {10.1186/s12885-018-4029-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226763},
  year      = {2018},
  abstract  = {Background There is no international consensus up to which age women with a diagnosis of triple-negative breast cancer (TNBC) and no family history of breast or ovarian cancer should be offered genetic testing for germline BRCA1 and BRCA2 (gBRCA) mutations. Here, we explored the association of age at TNBC diagnosis with the prevalence of pathogenic gBRCA mutations in this patient group. Methods The study comprised 802 women (median age 40 years, range 19-76) with oestrogen receptor, progesterone receptor, and human epidermal growth factor receptor type 2 negative breast cancers, who had no relatives with breast or ovarian cancer. All women were tested for pathogenic gBRCA mutations. Logistic regression analysis was used to explore the association between age at TNBC diagnosis and the presence of a pathogenic gBRCA mutation. Results A total of 127 women with TNBC(15.8\%) were gBRCA mutation carriers (BRCA1: n = 118, 14.7\%; BRCA2: n = 9, 1. 1\%). The mutation prevalence was 32.9\% in the age group 20-29 years compared to 6.9\% in the age group 60-69 years. Logistic regression analysis revealed a significant increase of mutation frequency with decreasing age at diagnosis (odds ratio 1.87 per 10 year decrease, 95\% CI 1.50-2.32, p < 0.001). gBRCA mutation risk was predicted to be > 10\% for women diagnosed below approximately 50 years. Conclusions Based on the general understanding that a heterozygous mutation probability of 10\% or greater justifies gBRCA mutation screening, women with TNBC diagnosed before the age of 50 years and no familial history of breast and ovarian cancer should be tested for gBRCA mutations. In Germany, this would concern approximately 880 women with newly diagnosed TNBC per year, of whom approximately 150 are expected to be identified as carriers of a pathogenic gBRCA mutation.},
  language  = {en}
}