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Cortesi L, Baldassarri B, Ferretti S, Razzaboni E, Bella M, Bucchi L, Canuti D, De Iaco P, De Santis G, Falcini F, Galli V, Godino L, Leoni M, Perrone AM, Pignatti M, Saguatti G, Santini D, Sassoli de'Bianchi P, Sebastiani F, Taffurelli M, Tazzioli G, Turchetti D, Zamagni C, Naldoni C. A regional population-based hereditary breast cancer screening tool in Italy: First 5-year results. Cancer Med 2020; 9:2579-2589. [PMID: 32045136 PMCID: PMC7131858 DOI: 10.1002/cam4.2824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background Up to 10% of individuals with breast cancer (BC) belong to families with hereditary syndromes. The aim of this study was to develop an instrument to identify individuals/families at high‐hereditary risk for BC and offer dedicated surveillance programs according to different risks. Methods The instrument consisted of a primary questionnaire collecting history of BC and ovarian cancer (OC). This questionnaire was applied to women enrolled in the Emilia‐Romagna Breast Cancer Screening Program. General practitioners (GPs) and specialists could propose the same questionnaire too. Women with a score of ≥ 2, were invited to complete an oncogenetic counseling. According to the Tyrer‐Cuzick evaluation, women considered at high risk were invited to involve the most representative alive individual of the family affected with BC/OC for BRCA1/2 genetic testing. Results Since January 2012 and December 2016, 660 040 women were evaluated by the regional screening program, of which 22 289 (3.5%) were invited to the Spoke evaluation, but only 5615 accepted (25.2%). Totally, also considering women sent by GPs and specialists, 11 667 were assessed and 5554 were sent to the Hub evaluation. Finally, 2342 (42.8%) women fulfilled the criteria for genetic testing, and 544 (23.2%) resulted BRCA1/2 mutation carriers. Conclusions To our knowledge, this is the first regional population‐based multistep model that is aimed to identify individuals with BRCA1/2 mutations and to offer an intensive surveillance program for hereditary‐high risk women. This tool is feasible and effective, even if more efforts must be performed to increase the acceptance of multiple assessments by the study population.
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Affiliation(s)
- Laura Cortesi
- Department of Oncology and Haematology, Azienda Ospedaliero, Universitaria di Modena Ospedale Civile di Baggiovara, Modena, Italy
| | - Bruna Baldassarri
- Department of Health and Welfare, Emilia-Romagna Region, Bologna, Italy
| | - Stefano Ferretti
- Department of Health and Welfare, Emilia-Romagna Region, Bologna, Italy
| | - Elisabetta Razzaboni
- Department of Oncology and Haematology, Azienda Ospedaliero, Universitaria di Modena Ospedale Civile di Baggiovara, Modena, Italy
| | - Mariangela Bella
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Lauro Bucchi
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Debora Canuti
- Cancer Screening Unit, Local Health Agency of Romagna, Rimini, Italy
| | - Pierandrea De Iaco
- Unit of Oncologic Gynecology, Department of Obstetrics and Gynecology, University of Bologna, Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Giorgio De Santis
- Division of Plastic Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.,Azienda Usl della Romagna, Forlì, Italy
| | - Vania Galli
- AUSL Modena, Mammography Screening Centre, Modena, Italy
| | - Lea Godino
- Department of Medical and Surgical Sciences, University of Bologna, Hospital of Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Maurizio Leoni
- Oncology Unit, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Anna Myriam Perrone
- Unit of Oncologic Gynecology, Department of Obstetrics and Gynecology, University of Bologna, Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Marco Pignatti
- Division of Plastic Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianni Saguatti
- Senology Unit, Bellaria Carlo Alberto Pizzardi Hospital, Bologna, Italy
| | - Donatella Santini
- Sant'Orsola-Malpighi Polyclinic, University of Bologna, Hospital of Bologna, Bologna, Italy
| | | | - Federica Sebastiani
- Department of Oncology and Haematology, Azienda Ospedaliero, Universitaria di Modena Ospedale Civile di Baggiovara, Modena, Italy
| | - Mario Taffurelli
- Department of the Health of Woman, Child and Urological Diseases, University of Bologna, Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Giovanni Tazzioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniela Turchetti
- Department of Medical and Surgical Sciences, University of Bologna, Hospital of Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Claudio Zamagni
- Department of Hematology and Oncology, University of Bologna, Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Carlo Naldoni
- Department of Health and Welfare, Emilia-Romagna Region, Bologna, Italy
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