Hereditary breast and ovarian cancer genetic testing in unselected patients: example of private supplementation of public healthcare service

Fam Cancer. 2024 Nov 20;24(1):7. doi: 10.1007/s10689-024-00426-8.

Abstract

In the Emilia-Romagna region (Northern Italy), the identification and management of women at familial/hereditary risk of breast and ovarian cancer is guided by a well-established regional protocol. Here we report the results of the experience of private supplementation of public healthcare service in offering the possibility to undergo BRCA1/2 testing and/or multigene panel testing (MGPT) within a well-defined pathway to women unfulfilling regional criteria. Out of 177 patients referred to our center who underwent BRCA1/2 testing, 175 tested negative while two (1.1%) resulted carriers of pathogenic variants in BRCA2; 69 patients also underwent MGPT, and in four cases (5.8%) a pathogenic variant were found (two in ATM and one in CHEK2 and RAD51C, respectively). Overall, this private supplementation of territorial public healthcare system has made it possible to confirm the validity of regional criteria for genetic testing access (concordance: 98.9%), but also to identify carriers of pathogenic variants of BRCA1/2 that would have escaped regional protocol, to support the effectiveness of MGPT for the identification of rare cases (not BRCA) at mild/high risk, and to provide reassurance to women who were found to be non-carriers of pathogenic variants, who may benefit from a more accurate assessment of their risk.

Keywords: BRCA1; BRCA2; Breast cancer; Ovarian cancer.

MeSH terms

  • Adult
  • Aged
  • Ataxia Telangiectasia Mutated Proteins / genetics
  • BRCA1 Protein / genetics
  • BRCA2 Protein* / genetics
  • Breast Neoplasms / genetics
  • Checkpoint Kinase 2* / genetics
  • DNA-Binding Proteins
  • Female
  • Genetic Predisposition to Disease
  • Genetic Testing* / methods
  • Genetic Testing* / statistics & numerical data
  • Hereditary Breast and Ovarian Cancer Syndrome / genetics
  • Humans
  • Italy
  • Middle Aged
  • Ovarian Neoplasms* / genetics

Substances

  • CHEK2 protein, human
  • Checkpoint Kinase 2
  • BRCA2 Protein
  • BRCA2 protein, human
  • BRCA1 protein, human
  • BRCA1 Protein
  • RAD51C protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • ATM protein, human
  • DNA-Binding Proteins