Accuracy of BRCA1/2 mutation prediction models for different ethnicities and genders: Experience in a southern Chinese cohort

Background: BRCA1/2 mutation prediction models (BRCAPRO, Myriad II, Couch, Shattuck-Eidens, BOADICEA) are well established in western cohorts to estimate the probability of BRCA1/2 mutations. Results: are conflicting in Asian populations. Most studies did not account for gender-specific prediction. We evaluated the performance of these models in a Chinese cohort, including males, before BRCA1/2 mutation testing. Methods: The five risk models were used to calculate the probability of BRCA mutations in probands with breast and ovarian cancers; 267 were non-BRCA mutation carriers (247 females and 20 males) and 43 were BRCA mutation carriers (38 females and 5 males). Results: Mean BRCA prediction scores for all models were statistically better for carriers than noncarriers for females but not for males. BRCAPRO overestimated the numbers of female BRCA1/2 mutation carriers at thresholds ≥20% but underestimated if <20%. BRCAPRO and BOADICEA underestimated the number of male BRCA1/2 mutation carriers whilst Myriad II underestimated the number of both male and female carriers. In females, BRCAPRO showed similar discrimination, as measured by the area under the receiver operator characteristic curve (AUC) for BRCA1/2 combined mutation prediction to BOADICEA, but performed better than BOADICEA in BRCA1 mutation prediction (AUC 93% vs. 87%). BOADICEA had the best discrimination for BRCA1/2 combined mutation prediction (AUC 87%) in males. Conclusions: The variation in model performance underscores the need for research on larger Asian cohorts as prediction models, and the possible need for customizing these models for different ethnic groups and genders. © The Author(s) 2012.published_or_final_versio

Comparison of fluorescence in-situ hybridisation with dual-colour in-situ hybridisation for assessment of HER2 gene amplification of breast cancer in Hong Kong

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Decision aids for breast cancer surgery: a randomised controlled trial

In Chinese women who require breast cancer surgery, use of a decision aid booklet reduces decisional conflict, treatment decision-making difficulty, and post-surgery decision regret. Decision aids should be available as part of the routine clinical service, specifically to support post-consultation decision making.published_or_final_versio

Breast-conserving surgery in young Chinese patients

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Breast conserving surgery in Hong Kong Chinese women

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Response to neoadjuvant chemotherapy and hormonotherapy in Chinese women with breast cancer

OBJECTIVES: There is an increase use of neoadjuvant chemo-hormonotherapy in the management of breast cancer in the past years. A variety of treatment regimens resulted in different efficacy and tolerability. This study aims to review the local experience of using such modality in a university breast surgical center. METHODS: A retrospective study of patients with breast cancer who received neoadjuvant chemotherapy or hormonal therapy followed by definitive surgery from January 2002 to December 2006 was performed. RESULTS: 91 patients received neoadjuvant chemotherapy during the study period. 53 patients received anthracycline-based regimen (AC only), 37 patients anthracycline and taxane-based regimen (AC + T) and 1 patient had additional Trastuzumab after receiving anthracycline and taxane (AC + TH). The pathologic complete response rates of AC only, AC + T and AC + TH were 9.4% (5/53), 24.3% (9/37) and 100.0% (1/1), respectively. Number of cycles and tumor size were significant factors affecting the pCR rate after neoadjuvant chemotherapy. Grade 4 toxicity was observed in 12.2% of patients during AC treatment and in 15.8% of patients during docetaxel treatment. 81 patients received aromatase inhibitors (AI) as neoadjuvant hormonal therapy. The pCR rate of AI was 1.2% (1/81) and none of the patients experienced grade 3 or 4 toxicity. CONCLUSIONS: The efficacy and tolerability of neoadjuvant therapy are similar in our population as compared with the Western countries. Neoadjuvant chemotherapy could achieve a higher response rate but neoadjuvant hormonotherapy was better tolerated.Link_to_subscribed_fulltex