Proceedings of the International Consensus Conference on Breast Cancer Risk, Genetics, & Risk Management, April, 2007

Authors

  • Gordon F. Schwartz MD, MBA, FACS,

    Corresponding author
    1. Department of Surgery, Jefferson Medical College, Philadelphia, Pennsylvania
    • Jefferson Medical College, 1015 Chestnut Street, Suite 510, Philadelphia, PA===

    Search for more papers by this author
    • Fax: (215) 627-3925

  • Kevin S. Hughes MD, FACS,

    1. Department of Surgery, Harvard Medical School, and Avon Comprehensive Breast Center, Massachusetts General Hospital, Boston, Massachusetts
    Search for more papers by this author
  • Henry T. Lynch MD,

    1. Department of Preventative Medicine, Medical Oncology, Creighton University School of Medicine, Omaha, Nebraska
    Search for more papers by this author
  • Carol J. Fabian MD,

    1. Department of Medicine, Breast Cancer Prevention Center, University of Kansas Medical Center, Kansas City, Kansas
    Search for more papers by this author
  • Ian S. Fentiman MD, DSc, FRCS,

    1. Department of Surgical Oncology, Guy's & St. Thomas NHS Trust, London, UK
    Search for more papers by this author
  • Mark E. Robson MD,

    1. Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, New York
    Search for more papers by this author
  • Susan M. Domchek,

    1. Department of Cancer Research, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    Search for more papers by this author
  • Lynn C. Hartmann MD,

    1. Department of Oncology, Mayo Clinic Cancer Center, Rochester, Minnesota
    Search for more papers by this author
  • Roland Holland MD, PhD,

    1. Center for Breast Cancer Screening, University Hospital Nijmegen, Nijmegen, The Netherlands
    Search for more papers by this author
  • David J. Winchester MD, FACS,

    1. Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    Search for more papers by this author
  • and the Consensus Conference Committee

    Search for more papers by this author
    • The International Consensus Conference Committee: Benjamin O. Anderson, MD, University of Washington, Seattle, WA; Banu K. Arun, MD, M. D. Anderson Cancer Center, Houston, TX; Harry Bartolink, MD, PhD, The Netherlands Cancer Institute, Amsterdam, Netherlands; Philip Bernard, MD, University of Utah, Salt Lake City, UT; Bernardo Bonanni, MD, European Institute of Oncology, Milan, Italy; Blake Cady, MD, Brown University School of Medicine, Providence, RI; Krishna B. Clough, MD, Paris Breast Center (Institute du Seine), Paris, France; Susan M. Domchek, MD, University of Pennsylvania, Philadelphia PA; Carol J. Fabian, MD, University of Kansas Medical Center, Kansas City, KS; Stephen A. Feig, MD, University of California Irvine, School of Medicine, Orange, CA; Ian S. Fentiman, MD, Guy's Hospital, London, UK; Lynn C. Hartmann, MD, Mayo Clinic Cancer Center, Rochester, MN; Sylvia H. Heywang-Kobrunner, MD, Leiterin des Referenzzentrum Mammographie, Munich, Germany; Roland Holland MD, PhD, National Expert and Training Centre for Breast Cancer Screening, Nijmegen, Netherlands; Anthony Howell, MD, Christie Hospital NHS Trust, Manchester, UK; Kevin S. Hughes, MD, Massachusetts General Hospital, Boston, Massachusetts; Claudine Isaacs, MD, Georgetown University, Washington, DC; Daniel B. Kopans, MD, Massachusetts General Hospital, Boston, MA; Henry T. Lynch, MD, Creighton University School of Medicine, Omaha; Robert E. Mansel, MD, Wales College of Medicine, Cardiff, Wales, UK; Shahla Masood, MD, University of Florida Health Science Center, Jacksonville, Florida; Juan P. Palazzo, MD, Jefferson Medical College, Philadelphia, PA; Mark E. Robson, MD, Memorial Sloan-Kettering Cancer Center, New York, NY; Gordon F. Schwartz, MD, MBA, Jefferson Medical College, Philadelphia, PA; Lawrence J. Solin, MD, University of Pennsylvania School of Medicine, Philadelphia, PA; Michael Untch, MD, Academic Hospital of the University Charite Berlin, Berlin, Germany; David J. Winchester, MD, Northwestern University Feinberg School of Medicine, Evanston, IL.


Abstract

A consensus conference including 30 experts was held in April, 2007, to discuss risk factors for breast cancer and their management. Four categories of risk were outlined, from “average” through “very high” risk, the latter including individuals with high penetrance BRCA1/2 gene mutations. Guidelines for management of patients in each of these categories were discussed, with the major portion of the conference devoted to individuals with BRCA1/2 mutations. Prevalence of these mutations in the general population was estimated to be 1 in 250-500 individuals, with an increased prevalence in Ashkenazi Jews and other founder groups. Risk-reduction strategies for these individuals included surveillance, with or without chemoprevention drugs, or surgical procedures to remove the organs at risk, ie, bilateral mastectomy and/or bilateral salpingo-oophorectomy. These risk reduction strategies were evaluated fully, and recommendations were made for the care of patients in each risk category. These guidelines for patient care were approved by the entire group of experts. Cancer 2008. © 2008 American Cancer Society.

Ancillary