Abstract
Objectives
To review non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes.
Content
Women with a gBRCA1 or 2 mutations face a high cumulative breast and ovarian cancer risk. While bilateral mastectomy (PBM) and bilateral salpingo-oophrectomy (PBSO) profoundly reduce the respective cancer risks, they are also associated with considerable side effects. There is therefore an urgent need for alternative and non-surgical risk reduction options. Tamoxifen and aromatase inhibitors have both been evaluated in secondary prevention, but their benefit in primary prevention is currently unknown in BRCA mutation carriers. In addition, their use is compromised by their side effect profile which makes them less appealing for a use in chemoprevention.
Summary and outlook
Denosumab is a well-tolerated osteoprotective drug, which has been demonstrated to have a potential preventive effect particularly in BRCA1-deficient models in vitro. The prospectively randomized double-blind BRCA-P trial is currently investigating the preventative effect of denosumab in healthy BRCA1 germ line mutation carriers.
Funding source: Shiraz University of Medical Sciences
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Research funding: This work is supported by deputy chancellor of Shiraz University of Medical Sciences.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: None declared.
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Informed consent: The study protocol was described to each participant and a written informed consent was taken.
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Ethical approval: The study protocol was approved by local Ethics Council of Shiraz University of Medical Sciences and was in accordance to Helsinki Declaration revision of 2008.
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