講演情報
[OE1-1]1047例超の乳癌を元に予測したBRCA遺伝学的検査の予測件数と遺伝医療へのアクセシビリティ
○大田 浩司1, 伊藤 朋子1, 畑 郁江2, 加藤 じゅん2, 巨田 元礼2 (1.福井県立病院 外科, 2.福井県立病院 遺伝診療科)
The aim of this study was to accurately predict the number of BRCA tests based on 1,047 operable breast cancer (BC) cases and to consider their accessibility to clinical genetics. In addition, as Olaparib is going to be available for the adjuvant setting, we also investigated the number of eligible patients.Patients and methods: 1,047 BC patients who had received an operation between January 2010 and December 2021 in our hospital were enrolled. The predictive number of BRCA tests and the number of eligible patients for adjuvant Olaparib were calculated based on testing criteria produced by Japanese Breast Cancer Society (JBCS) and eligibility criteria of the OlympiA trial respectively.Results: Patients in their 20’s accounted for 0.3% of the total and 30’s for 4.6%, 40’s for 24.3%, 50’s for 22.2%, 60’s for 24.5%, 70’s for 17.1%, and 80’s and over for 7.2%. Four hundred twenty-four patients (40.3% of the total) met at least one criterion of JBCS and more than half of these patients were aged 40’s or younger. Furthermore, we predicted that an additional 52 cases (5.2% of the total) based on OlympiA eligible criteria may be added when adjuvant Olaparib becomes available. Consideration and conclusion: This study indicated 40.3% of all operable BC patients met the JBCS criteria and adjuvant Olaparib may add an additional 5.2% of potential candidates. Based on these results, we should consider a new strategy, such as prioritizing younger patients or simplifying pre-testing genetic counseling, for future clinical setting of HBOC because of limited human resources.