Online Tool to Guide Decisions for BRCA1/2 Mutation Carriers.

Kurian AW, Munoz DF, Rust P, Schackmann EA, Smith M, Clarke L, Mills MA, Plevritis SK.

Source

Allison W. Kurian, Diego F. Munoz, Elizabeth A. Schackmann, Meredith A. Mills, and Sylvia K. Plevritis, Stanford University School of Medicine, Stanford, CA; Peter Rust, Michael Smith, and Lauren Clarke, Cornerstone Systems Northwest, Lynden, WA.

Abstract

PURPOSEWomen with BRCA1 or BRCA2 (BRCA1/2) mutations must choose between prophylactic surgeries and screening to manage their high risks of breast and ovarian cancer, comparing options in terms of cancer incidence, survival, and quality of life. A clinical decision tool could guide these complex choices. METHODSWe built a Monte Carlo model for BRCA1/2 mutation carriers, simulating breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years and prophylactic mastectomy (PM) and/or prophylactic oophorectomy (PO) at various ages. Modeled outcomes were cancer incidence, tumor features that shape treatment recommendations, overall survival, and cause-specific mortality. We adapted the model into an online tool to support shared decision making. RESULTS: //brcatool.stanford.edu" locator-type="url">http://brcatool.stanford.edu ).