Rate of BRCA mutation in patients tested under NCCN genetic testing criteria

BACKGROUND

BRCA genetic testing is recommended by the National Comprehensive Cancer Network (NCCN) in breast cancer patients who meet specific criteria. Limited data are available on the likelihood of detecting a mutation when these guidelines are followed.

METHODS

A retrospective chart review examined patients with breast cancer who underwent BRCA testing based on NCCN guidelines.

RESULTS

Twelve (6.0%) of the 199 patients had a deleterious BRCA mutation. Family history of BRCA mutations (50%, p = 0.019), age ≤45 at diagnosis (9.7%, p = 0.034) and meeting ≥3 NCCN criteria (13.3%, p = 0.03) yielded the highest rates of BRCA mutation. Having a family history of BRCA mutation and age ≤45 were associated with increased rate of BRCA mutation on multivariate analysis (OR 14.3, CI 1.2-166.3; OR 11.6, CI 1.2-108.6).

CONCLUSION

Select NCCN criteria are associated with higher rates of BRCA mutations. Waiting for genetic testing results to guide surgical management may be warranted in this subset of patients.

Assessment of optimal dose of diuretic associated with fixed dose of beta-blocking: a new experimental model based on multiple sampling of blood pressure performed by self-measurements

A new experimental model is presented for determining the optimum dose of 3 different doses (13 mg, 25 mg, 37 mg per day) of hydrochlorothiazide employed to enhance hypotensive effect of 200 mg/day of metoprolol in human hypertension. The model takes into account the circadian variability of blood pressure as sinusoidal function and wash-out effect as a linear trend so as to compensate for bias due to normal temporal variability.