Skip to main content

Advertisement

SpringerLink
Log in

Risk and Prevention for Highly Penetrant Genes

  • Risk and Prevention (ME Wood, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Approximately 10% of breast cancer cases are attributed to a hereditary predisposition. Here, we review the risks and management options for highly penetrant genes including BRCA1/2, TP53, PTEN, CDH1, STK11, and PALB2 which confer a 5 to greater than 10-fold increased risk of breast cancer, and an increased risk of other cancers.

Recent Findings

Risk-reducing salpingo-oophorectomy (RRSO) reduces mortality in BRCA1/2 carriers. Other management strategies are tailored to the hereditary cancer syndrome in question and include more intensive screening with imaging and serologic studies, risk-reducing surgeries such as mastectomy, and consideration of risk reduction agents.

Summary

Given the advances in our knowledge regarding the impact of management strategies in mutation carriers, genetic testing for high-penetrance breast cancer genes has become standard of care. It is critically important to discuss the implications of testing unaffected family members, in order to be able to offer impactful interventions to healthy at-risk individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30. https://doi.org/10.3322/caac.21332.

    Article  PubMed  Google Scholar 

  2. Foulkes WD. Inherited susceptibility to common cancers. N Engl J Med. 2008;359(20):2143–53. https://doi.org/10.1056/NEJMra0802968.

    Article  PubMed  CAS  Google Scholar 

  3. Alsop K, Fereday S, Meldrum C, deFazio A, Emmanuel C, George J, et al. BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: a report from the Australian ovarian Cancer study group. J Clin Oncol. 2012;30:2654–63. https://doi.org/10.1200/JCO.2011.39.8545.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Couch, Fergus. SABCS 2016.

  5. Peshkin BN, Isaacs C (2018). Prevalence of BRCA1 and BRCA2 mutations and associated cancer risks. In T. W. Post (Ed.), UpToDate. Retrieved from http://www.uptodate.com

  6. Kuchenbaecker KB, Hopper JL, Barnes DR, Phillips KA, Mooij TM, Roos-Blom MJ, et al. Risks of breast, ovarian, and contralateral breast Cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017;317:2402–16. https://doi.org/10.1001/jama.2017.7112.

    Article  PubMed  CAS  Google Scholar 

  7. Brose MS, Rebbeck TR, Calzone KA, Stopfer JE, Nathanson KL, Weber BL. Cancer risk estimates for BRCA1 mutation carriers identified in a risk evaluation program. J Natl Cancer Inst. 2002;94(18):1365–72.

    Article  PubMed  CAS  Google Scholar 

  8. Aziz S, Kuperstein G, Rosen B, Cole D, Nedelcu R, McLaughlin J, et al. A genetic epidemiological study of carcinoma of the fallopian tube. Gynecol Oncol. 2001;80(3):341–5.

    Article  PubMed  CAS  Google Scholar 

  9. Curtis RE, Ron E, Hankey BF, Hoover RN. New malignancies following breast cancer. In: Curtis RE, Freedman DM, Ron E, et al (editors). 2006, pages 189–214.

  10. Malone KE, Begg CB, Haile RW, Borg A, Concannon P, Tellhed L, et al. Population-based study of the risk of second primary contralateral breast cancer associated with carrying a mutation in BRCA1 or BRCA2. J Clin Oncol. 2010;28(14):2404–10. https://doi.org/10.1200/JCO.2009.24.2495.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Rebbeck TR, Mitra N, Wan F, Sinilnikova OM, Healey S, McGuffog L, Mazoyer S, Chenevix-Trench G, Easton DF, Antoniou AC, Nathanson KL, CIMBA Consortium., Laitman Y, Kushnir A, Paluch-Shimon S, Berger R, Zidan J, Friedman E, Ehrencrona H, Stenmark-Askmalm M, Einbeigi Z, Loman N, Harbst K, Rantala J, Melin B, Huo D, Olopade OI, Seldon J, Ganz PA, Nussbaum RL, Chan SB, Odunsi K, Gayther SA, Domchek SM, Arun BK, Lu KH, Mitchell G, Karlan BY, Walsh C, Lester J, Godwin AK, Pathak H, Ross E, Daly MB, Whittemore AS, John EM, Miron A, Terry MB, Chung WK, Goldgar DE, Buys SS, Janavicius R, Tihomirova L, Tung N, Dorfling CM, van Rensburg E, Steele L, Neuhausen SL, Ding YC, Ejlertsen B, Gerdes AM, Hansen Tv, Ramón y Cajal T, Osorio A, Benitez J, Godino J, Tejada MI, Duran M, Weitzel JN, Bobolis KA, Sand SR, Fontaine A, Savarese A, Pasini B, Peissel B, Bonanni B, Zaffaroni D, Vignolo-Lutati F, Scuvera G, Giannini G, Bernard L, Genuardi M, Radice P, Dolcetti R, Manoukian S, Pensotti V, Gismondi V, Yannoukakos D, Fostira F, Garber J, Torres D, Rashid MU, Hamann U, Peock S, Frost D, Platte R, Evans DG, Eeles R, Davidson R, Eccles D, Cole T, Cook J, Brewer C, Hodgson S, Morrison PJ, Walker L, Porteous ME, Kennedy MJ, Izatt L, Adlard J, Donaldson A, Ellis S, Sharma P, Schmutzler RK, Wappenschmidt B, Becker A, Rhiem K, Hahnen E, Engel C, Meindl A, Engert S, Ditsch N, Arnold N, Plendl HJ, Mundhenke C, Niederacher D, Fleisch M, Sutter C, Bartram CR, Dikow N, Wang-Gohrke S, Gadzicki D, Steinemann D, Kast K, Beer M, Varon-Mateeva R, Gehrig A, Weber BH, Stoppa-Lyonnet D, Sinilnikova OM, Mazoyer S, Houdayer C, Belotti M, Gauthier-Villars M, Damiola F, Boutry-Kryza N, Lasset C, Sobol H, Peyrat JP, Muller D, Fricker JP, Collonge-Rame MA, Mortemousque I, Nogues C, Rouleau E, Isaacs C, de Paepe A, Poppe B, Claes K, de Leeneer K, Piedmonte M, Rodriguez G, Wakely K, Boggess J, Blank SV, Basil J, Azodi M, Phillips KA, Caldes T, de la Hoya M, Romero A, Nevanlinna H, Aittomäki K, van der Hout A, Hogervorst FB, Verhoef S, Collée JM, Seynaeve C, Oosterwijk JC, Gille JJ, Wijnen JT, Gómez Garcia EB, Kets CM, Ausems MG, Aalfs CM, Devilee P, Mensenkamp AR, Kwong A, Olah E, Papp J, Diez O, Lazaro C, Darder E, Blanco I, Salinas M, Jakubowska A, Lubinski J, Gronwald J, Jaworska-Bieniek K, Durda K, Sukiennicki G, Huzarski T, Byrski T, Cybulski C, Toloczko-Grabarek A, Złowocka-Perłowska E, Menkiszak J, Arason A, Barkardottir RB, Simard J, Laframboise R, Montagna M, Agata S, Alducci E, Peixoto A, Teixeira MR, Spurdle AB, Lee MH, Park SK, Kim SW, Friebel TM, Couch FJ, Lindor NM, Pankratz VS, Guidugli L, Wang X, Tischkowitz M, Foretova L, Vijai J, Offit K, Robson M, Rau-Murthy R, Kauff N, Fink-Retter A, Singer CF, Rappaport C, Gschwantler-Kaulich D, Pfeiler G, Tea MK, Berger A, Greene MH, Mai PL, Imyanitov EN, Toland AE, Senter L, Bojesen A, Pedersen IS, Skytte AB, Sunde L, Thomassen M, Moeller ST, Kruse TA, Jensen UB, Caligo MA, Aretini P, Teo SH, Selkirk CG, Hulick PJ, Andrulis I Association of type and location of BRCA1 and BRCA2 mutations with risk of breast and ovarian cancer. JAMA 2015;313(13):1347–1361. doi: https://doi.org/10.1001/jama.2014.5985.

  12. Tai YC, Domchek S, Parmigiani G, Chen S. Breast cancer risk among male BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst. 2007;99(23):1811–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Breast Cancer Linkage Consortium. Cancer risks in BRCA2 mutation carriers. J Natl Cancer Inst. 1999;91(15):1310–6.

    Article  Google Scholar 

  14. Levine DA, Argenta PA, Yee CJ, Marshall DS, Olvera N, Bogomolniy F, et al. Fallopian tube and primary peritoneal carcinomas associated with BRCA mutations. J Clin Oncol. 2003;21(22):4222–7.

    Article  PubMed  CAS  Google Scholar 

  15. NCCN Practice Guidelines Hereditary Breast and/or Ovarian Cancer v.1.2018.

  16. Pijpe A, Andrieu N, Easton DF, Kesminiene A, Cardis E, Noguès C. Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK). BMJ. 2012;345:e5660. https://doi.org/10.1136/bmj.e5660.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Warner E, Hill K, Causer P, Plewes D, Jong R, Yaffe M, et al. Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging. J Clin Oncol. 2011;29(13):1664–9. https://doi.org/10.1200/JCO.2009.27.0835.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Riedl CC, Luft N, Bernhart C, Weber M, Bernathova M, Tea MK, et al. Triple-modality screening trial for familial breast cancer underlines the importance of magnetic resonance imaging and questions the role of mammography and ultrasound regardless of patient mutation status, age, and breast density. J Clin Oncol. 2015;33(10):1128–35. https://doi.org/10.1200/JCO.2014.56.8626.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Heemskerk-Gerritsen BA, Brekelmans CT, Menke-Pluymers MB, van Geel AN, Tilanus-Linthorst MM, Bartels CC, et al. Prophylactic mastectomy in BRCA1/2 mutation carriers and women at risk of hereditary breast cancer: long-term experiences at the Rotterdam Family Cancer Clinic. Ann Surg Oncol. 2007;14(12):3335–44.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Domchek SM, Friebel TM, Singer CF, Evans DG, Lynch HT, Isaacs C, et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;304(9):967–75. https://doi.org/10.1001/jama.2010.1237.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Ludwig KK, Neuner J, Butler A, Geurts JL, Kong AL, et al. Risk reduction and survival benefit of prophylactic surgery in BRCA mutation carriers, a systematic review. Am J Surg. 2016;212(4):660–9. https://doi.org/10.1016/j.amjsurg.2016.06.010.

    Article  PubMed  Google Scholar 

  22. Brandberg Y, Sandelin K, Erikson S, Jurell G, Liljegren A, Lindblom A, et al. Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: a prospective 1-year follow-up study. J Clin Oncol. 2008;26(24):3943–9. https://doi.org/10.1200/JCO.2007.13.9568.

    Article  PubMed  Google Scholar 

  23. Jakub JW, Peled AW, Gray RJ, Greenup RA, Kiluk JV, Sacchini V, et al. Oncologic safety of prophylactic nipple-sparing mastectomy in a population with BRCA mutations: a multi-institutional study. JAMA Surg. 2018;153(2):123–9. https://doi.org/10.1001/jamasurg.2017.3422.

    Article  PubMed  Google Scholar 

  24. Eisen A, Lubinski J, Klijn J, Moller P, Lynch HT, Offit K, et al. Breast cancer risk following bilateral oophorectomy in BRCA1 and BRCA2 mutation carriers: an international case-control study. J Clin Oncol. 2005;23(30):7491–6.

    Article  PubMed  Google Scholar 

  25. Heemskerk-Gerritsen BA, Seynaeve C, van Asperen CJ, Ausems MG, Collée JM, van Doorn HC, et al. Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J Natl Cancer Inst. 2015;107(5) https://doi.org/10.1093/jnci/djv033.

  26. Chai X, Domchek S, Kauff N, Rebbeck T, Chen J. RE: breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J Natl Cancer Inst. 2015;107(9) https://doi.org/10.1093/jnci/djv217.

  27. Kotsopoulos J, Huzarski T, Gronwald J, Singer CF, Moller P, Lynch HT, et al. Bilateral oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst. 2016;109(1):djw177. https://doi.org/10.1093/jnci/djw177.

    Article  PubMed  Google Scholar 

  28. Domchek SM, Friebel T, Neuhausen SL, Lynch HT, Singer CF, Eeles RA, Isaacs C, Tung NM, Ganz PA, Couch FJ, Weitzel JN, Olopade OI, Rubinstein WS, Tomlinson GE, Pichert GC, Daly MB, Matloff ET, Evans DG, Garber JE, Rebbeck TR, PROSE Consortium Is hormone replacement therapy (HRT) following risk-reducing salpingo-oophorectomy (RRSO) in BRCA1 (B1)- and BRCA2 (B2)-mutation carriers associated with an increased risk of breast cancer. J Clin Oncol 29: 2011 (suppl; abstr 1501). 2011 ASCO Annual Meeting.

  29. Phillips KA, Milne RL, Rookus MA, Daly MB, Antoniou AC, Peock S, et al. Tamoxifen and risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. J Clin Oncol. 2013;31(25):3091–9. https://doi.org/10.1200/JCO.2012.47.8313.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Peshkin BN, Isaacs C (2017). Overview of hereditary breast and ovarian cancer syndromes. In T. W. Post (Ed.), UpToDate. Retrieved from http://www.uptodate.com.

  31. Liu KH, Skates S, Hernandez MA, Bedi D, Bevers T, Leeds L, et al. A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value. Cancer. 2013;119(19):3454–61. https://doi.org/10.1002/cncr.28183.

    Article  Google Scholar 

  32. Finch AP, Lubinski J, Moller P, Singer CF, Karlan B, Senter L, et al. Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation. J Clin Oncol. 2014;32(15):1547–53. https://doi.org/10.1200/JCO.2013.53.2820.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Segev Y, Iqbal J, Lubinski, Gronwald J, Lynch HT, Moller PJ, et al. The incidence of endometrial cancer in women with BRCA1 and BRCA2 mutations: an international prospective cohort study. Gynecol Oncol. 2013;130(1):127–31. https://doi.org/10.1016/j.ygyno.2013.03.027.

    Article  PubMed  CAS  Google Scholar 

  34. Shu CA, Pike MC, Jotwani AR, Friebel TM, Soslow RA, Levine DA, et al. Uterine Cancer after risk-reducing salpingo-oophorectomy without hysterectomy in women with BRCA mutations. JAMA Oncol. 2016;2(11):1434–40. https://doi.org/10.1001/jamaoncol.2016.1820.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Moorman PG, Havrilesky LJ, Gierisch JM, Coeytaux RR, Lowery WJ, Peragallo Urrutia R, et al. Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis. J Clin Oncol. 2013;31(33):4188–98. https://doi.org/10.1200/JCO.2013.48.9021.

    Article  PubMed  CAS  Google Scholar 

  36. Iodice S, Barile M, Rotmensz N, Feroce I, Bonanni B, Radice P, et al. Oral contraceptive use and breast or ovarian cancer risk in BRCA1/2 carriers: a meta-analysis. Eur J Cancer. 2010;46(12):2275–84. https://doi.org/10.1016/j.ejca.2010.04.018.

    Article  PubMed  CAS  Google Scholar 

  37. Schrijver LH, Olsson H, Antonis A, Milne R, Phillips K, Andrieu N, et al. Oral contraceptive use and breast cancer risk: a cohort study of BRCA1 and mutation carriers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1–5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017:77(13 Suppl):Abstract nr 4276, Abstract 4276: Oral contraceptive use and breast cancer risk: a cohort study ofBRCA1andBRCA2mutation carriers.

  38. Micropoulos C, Selkirk CGH, Saya S, Bancroft E, Vertosick E, Dadaev T, et al. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition. Br J Cancer. 2018;118(2):266–76. https://doi.org/10.1038/bjc.2017.429.

    Article  Google Scholar 

  39. Evans DG (2017). Li-fraumeni syndrome. In T. W. Post (Ed.), UpToDate. Retrieved from http://www.uptodate.com

  40. Couch FJ, Shimelis H, Hu C, Hart SN, Polley EC, Na J, et al. Associations between cancer predisposition testing panel genes and breast Cancer. JAMA Oncol. 2017;3(9):1190–6. https://doi.org/10.1001/jamaoncol.2017.0424.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Olivier M, Goldgar DE, Sodha N, Ohgaki H, Kleihues P, Hainaut P, et al. Li-Fraumeni and related syndromes: correlation between tumor type, family structure, and TP53 genotype. Cancer Res. 2003;63(20):6643–50.

    PubMed  CAS  Google Scholar 

  42. Wilson JR, Bateman AC, Hanson H, An Q, Evans G, Rahman N, et al. A novel HER2-positive breast cancer phenotype arising from germline TP53 mutations. J Med Genet. 2010;47(11):771–4. https://doi.org/10.1136/jmg.2010.078113.

    Article  PubMed  CAS  Google Scholar 

  43. Birch JM, Hartley AL, Tricker KJ, Prosser J, Condie A, Kelsey AM, et al. Prevalence and diversity of constitutional mutations in the p53 gene among 21 Li-Fraumeni families. Cancer Res. 1994;54(5):1298–304.

    PubMed  CAS  Google Scholar 

  44. Villani A, Shore A, Wasserman JD, Stephens D, Kim RH, Druker H, et al. Biochemical and imaging surveillance in germline TP53 mutation carriers with Li-Fraumeni syndrome: 11 year follow-up of a prospective observational study. Lancet Oncol. 2016;17(9):1295–305. https://doi.org/10.1016/S1470-2045(16)30249-2.

    Article  PubMed  CAS  Google Scholar 

  45. Ballinger ML, Best A, Mai PL, Khincha PP, Loud JT, Peters JA, et al. Baseline surveillance in li-Fraumeni syndrome using whole-body magnetic resonance imaging: a meta-analysis. JAMA Oncol. 2017;3(12):1634–9. https://doi.org/10.1001/jamaoncol.2017.1968.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Pilarski R, Burt R, Kohlman W, Pho L, Shannon KM, Swisher E. Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst. 2013;105(21):1607–16. https://doi.org/10.1093/jnci/djt277.

    Article  PubMed  CAS  Google Scholar 

  47. Ngeow J, Sesock K, Eng C. Breast Cancer risk and clinical implications for germline PTEN mutation carriers. Breast Cancer Res Treat. 2017;165(1):1–8. https://doi.org/10.1007/s10549-015-3665-z.

    Article  PubMed  CAS  Google Scholar 

  48. Ngeow J, Stanuch K, Mester JL, Barnholtz-Sloan JS, Eng C. Second malignant neoplasms in patients with Cowden syndrome with underlying germline PTEN mutations. J Clin Oncol. 2014;32(17):1818–24. https://doi.org/10.1200/JCO.2013.53.6656.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  49. Tan MH, Mester JL, Ngeow J, Rybicki LA, Orloff MS, Eng C. Lifetime cancer risks in individuals with germline PTEN mutations. Clin Cancer Res. 2012;18(2):400–7. https://doi.org/10.1158/1078-0432.CCR-11-2283.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Bubien V, Bonnet F, Brouste V, Hoppe S, Barouk-Simonet E, David A, et al. High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. J Med Genet. 2013;50(4):255–63. https://doi.org/10.1136/jmedgenet-2012-101339.

    Article  PubMed  CAS  Google Scholar 

  51. Nieuwenhuis MH, Kets CM, Murphy-Ryan M, Yntema HG, Evans DG, Colas C. Cancer risk and genotype-phenotype correlations in PTEN hamartoma tumor syndrome. Familial Cancer. 2014;13(1):57–63. https://doi.org/10.1007/s10689-013-9674-3.

    Article  PubMed  CAS  Google Scholar 

  52. Hearle N, Schumacher V, Menko FH, Olschwang S, Boardman LA, Gille JJ, et al. Frequency and spectrum of cancers in the Peutz-Jeghers syndrome. Clin Cancer Res. 2006;12(10):3209–15.

    Article  PubMed  CAS  Google Scholar 

  53. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Colorectal Cancer Screening Version 2.2017. NCCN.org.

  54. Pharoah PD, Guilford P, Caldas C. International Gastric Cancer Linkage Consortium. Incidence of gastric cancer and breast cancer in CDH1 (E-cadherin) mutation carriers from hereditary diffuse gastric cancer families. Gastroenterology. 2001;121(6):1348–53.

    Article  PubMed  CAS  Google Scholar 

  55. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Gastric Cancer Version 5.2017. NCCN.org.

  56. Antoniou AC, Casadei S, Heikkinen T, Barrowdale D, Pylkäs K, Roberts J, et al. Breast-cancer risk in families with mutations in PALB2. N Engl J Med. 2014;371(6):497–506. https://doi.org/10.1056/NEJMoa1400382.a.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Lombardi Cancer Center at MedStar Georgetown University Hospital receives research funding from Tesaro for an investigator-initiated trial Dr. Claudine Isaacs co-leads.

Author information

Authors and Affiliations

  1. Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, 20010, USA

    Ami Chitalia

  2. Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC, 20007, USA

    Katia Khoury & Claudine Isaacs

Authors
  1. Ami Chitalia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katia Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudine Isaacs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudine Isaacs.

Ethics declarations

Conflict of Interest

Claudine Isaacs serves as consultant for Pfizer and Astra Zeneca.

Ami Chitalia and Katia Khoury declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Risk and Prevention

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chitalia, A., Khoury, K. & Isaacs, C. Risk and Prevention for Highly Penetrant Genes. Curr Breast Cancer Rep 10, 209–218 (2018). https://doi.org/10.1007/s12609-018-0282-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12609-018-0282-y

Keywords

Search

Navigation