Ann Lab Med 2020; 40(2): 114-121  https://doi.org/10.3343/alm.2020.40.2.114
BRCA1/BRCA2 Pathogenic Variant Breast Cancer: Treatment and Prevention Strategies
Anbok Lee, M.D, Ph.D.1, Byung-In Moon, M.D, Ph.D.2, and Tae Hyun Kim, M.D, Ph.D.1
1Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea; 2Department of Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
Corresponding author: Anbok Lee, M.D., Ph.D.
Department of Surgery, Busan Paik Hospital, Inje University, College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea
Tel: +82-51-890-6859 Fax: +82-51-898-9427 E-mail: ab-lee@hanmail.net
Received: May 14, 2019; Revised: August 21, 2019; Accepted: October 10, 2019; Published online: March 1, 2020.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Hereditary breast cancer is known for its strong tendency of inheritance. Most hereditary breast cancers are related to BRCA1/BRCA2 pathogenic variants. The lifelong risk of breast cancer in pathogenic BRCA1 and BRCA2 variant carriers is approximately 65% and 45%, respectively, whereas that of ovarian cancer is estimated to be 39% and 11%, respectively. Therefore, understanding these variants and clinical knowledge on their occurrence in breast cancers and carriers are important. BRCA1 pathogenic variant breast cancer shows more aggressive clinicopathological features than the BRCA2 pathogenic variant breast cancer. Compared with sporadic breast cancer, their prognosis is still debated. Treatments of BRCA1/BRCA2 pathogenic variant breast cancer are similar to those for BRCA-negative breast cancer, mainly including surgery, radiotherapy, and chemotherapy. Recently, various clinical trials have investigated poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor treatment for advanced-stage BRCA1/BRCA2 pathogenic variant breast cancer. Among the various PARP inhibitors, olaparib and talazoparib, which reached phase III clinical trials, showed improvement of median progression-free survival around three months. Preventive and surveillance strategies for BRCA pathogenic variant breast cancer to reduce cancer recurrence and improve treatment outcomes have recently received increasing attention. In this review, we provide an information on the clinical features of BRCA1/BRCA2 pathogenic variant breast cancer and clinical recommendations for BRCA pathogenic variant carriers, with a focus on treatment and prevention strategies. With this knowledge, clinicians could manage the BRCA1/BRCA2 pathogenic variant breast cancer patients more effectively.
Keywords: BRCA1/BRCA2 pathogenic variant, Breast cancer, Ovarian cancer, Treatment, Prevention



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