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Harinck F.,Erasmus University Rotterdam | Kluijt I.,Familial Cancer Clinic | Bruno M.J.,Erasmus University Rotterdam
European Gastroenterology and Hepatology Review | Year: 2012

With a median survival of four to six months and a five-year survival of less than 5 %, the prognosis of pancreaticcancer is poor. The cause lies mainly in the late occurrence of symptoms and the aggressiveness of this tumour type, whereby fewer than 20 % of symptomatic patients have resectable disease at time of diagnosis and even in these patients, radical resection produces a five-year survival of less than 20 %. Screening for precursor lesions or malignancies at an early asymptomatic stage could potentially offer a way to improve the prognosis, especially when offered to individuals with an already high baseline risk of developing pancreatic cancer. This article addresses these high-risk individuals. © Touch Briefings 2012.

Harrison W.J.,University of Sydney | Harrison W.J.,Kolling Institute of Medical Research | Andrici J.,University of Sydney | Andrici J.,Kolling Institute of Medical Research | And 26 more authors.
American Journal of Surgical Pathology | Year: 2016

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome secondary to germline fumarate hydratase (FH) mutation presents with cutaneous and uterine leiomyomas, and a distinctive aggressive renal carcinoma. Identification of HLRCC patients presenting first with uterine leiomyomas may allow early intervention for renal carcinoma. We reviewed the morphology and immunohistochemical (IHC) findings in patients with uterine leiomyomas and confirmed or presumed HLRCC. IHC was also performed on a tissue microarray of unselected uterine leiomyomas and leiomyosarcomas. FH-deficient leiomyomas underwent Sanger and massively parallel sequencing on formalin-fixed paraffin-embedded tissue. All 5 patients with HLRCC had at least 1 FH-deficient leiomyoma: defined as completely negative FH staining with positive internal controls. One percent (12/1152) of unselected uterine leiomyomas but 0 of 88 leiomyosarcomas were FH deficient. FHdeficient leiomyoma patients were younger (42.7 vs. 48.8 y, P=0.024) and commonly demonstrated a distinctive hemangiopericytomatous vasculature. Other features reported to be associated with FH-deficient leiomyomas (hypercellularity, nuclear atypia, inclusion-like nucleoli, stromal edema) were inconstantly present. Somatic FH mutations were identified in 6 of 10 informative unselected FH-deficient leiomyomas. None of these mutations were found in the germline. We conclude that, while the great majority of patients with HLRCC will have FHdeficient leiomyomas, 1% of all uterine leiomyomas are FH deficient usually due to somatic inactivation. Although IHC screening for FH may have a role in confirming patients at high risk for hereditary disease before genetic testing, prospective identification of FH-deficient leiomyomas is of limited clinical benefit in screening unselected patients because of the relatively high incidence of somatic mutations. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.

Nomizu T.,Familial Cancer Clinic | Matsuzaki M.,Familial Cancer Clinic | Katagata N.,Familial Cancer Clinic | Watanabe F.,Familial Cancer Clinic | Akama Y.,Nursing
Japanese Journal of Cancer and Chemotherapy | Year: 2012

The clinical features of familial breast cancer are characterized by early onset, high frequency of bilateral breast cancer, and multiple malignancies of other organs. It is strongly suggested that genetic factors contribute to familial breast cancer. The causative genes now identified are BRCA1 and BRCA2. This disease is called hereditary breast ovarian cancer syndrome (HBOC) because breast cancer and ovarian cancer are clustered in the kindred confirmed BRCA mutation. As for BRCA-related breast cancer, early onset and highly frequent bilateral breast cancer are characteristic. In addition, the histological grade is high and the positive rate of estrogen receptors is low in BRCA1-related breast cancer. Gene diagnosis of BRCA is useful when choosing a surgical method, chemotherapy, or a surveillance of mutation carriers. The problem in Japan is that the treatment is very expensive, with poor understanding of HBOC of by clinicians and as yet immature genetic counseling system.

De Brakeleer S.,Vrije Universiteit Brussel | De Greve J.,Vrije Universiteit Brussel | Loris R.,Vrije Universiteit Brussel | Janin N.,CHU de Liege | And 3 more authors.
Human Mutation | Year: 2010

Fifteen years ago BRCA1 and BRCA2 were reported as high penetrant breast cancer predisposing genes. However, mutations in these genes are found in only a fraction of high risk families. BARD1 is a candidate breast cancer gene, but only a limited number of missense mutations with rather unclear pathogenic consequences have been reported. We screened 196 high risk breast cancer families for the occurrence of BARD1 variants. All genetic variants were analyzed using clinical information as well as IN SILICO predictive tools, including protein modeling. We found three candidate pathogenic mutations in seven families including a first case of a protein truncating mutation (p.Glu652fs) removing the entire second BRCT domain of BARD1. In conclusion, we provide evidence for an increased breast cancer risk associated to specific BARD1 germline mutations. However, these BARD1 mutations occur in a minority of hereditary breast cancer families. ©2010 Wiley-Liss, Inc.

Toon C.W.,Northern Cancer Translational Research Unit | Walsh M.D.,University of Queensland | Walsh M.D.,Queensland Institute of Medical Research | Chou A.,SydPath | And 19 more authors.
American Journal of Surgical Pathology | Year: 2013

BRAFV600E mutation in microsatelliteunstable (MSI) colorectal carcinomas (CRCs) virtually excludes Lynch syndrome (LS). In microsatellite-stable (MSS) CRCs it predicts poor prognosis. We propose a universal CRC LS screening algorithm using concurrent reflex immunohistochemistry (IHC) for BRAFV600E and mismatch-repair (MMR) proteins. We compared BRAFV600E IHC with multiplex polymerase chain reaction (PCR) and matrix-assisted laser desorption/ionization- time of flight mass spectrometry in 216 consecutive CRCs from 2011. Discordant cases were resolved with real-time PCR. BRAFV600E IHC was performed on 51 CRCs from the Australasian Colorectal Cancer Family Registry (ACCFR), which were fully characterized for BRAF mutation by allele-specific PCR, MMR status (MMR IHC and MSI), MLH1 promoter methylation, and germline MLH1 mutation. We then assessed MMR and BRAFV600E IHC on 1403 consecutive CRCs. By matrix-assisted laser desorption/ionizationtime of flight mass spectrometry 15 cases did not yield a BRAF result, whereas 38/201 (19%) were positive. By IHC 45/216 (20%) were positive. Of the 7 discordant cases, real-time PCR confirmed the IHC result in 6. In the 51 CRCs from the ACCFR, IHC was concordant with allele-specific PCR in 50 cases. BRAFV600E and MSI IHC on 1403 CRCs demonstrated the following phenotypes: BRAF/MSS (1029 cases, 73%), BRAF+/MSS (98, 7%), BRAF+/MSI (183, 13%), and BRAF/MSI (93, 7%). All 11/1403 cancers associated with proven LS were BRAF/MSI. We conclude that BRAF IHC is highly concordant with 2 commonly used PCR-based BRAFV600E assays; it performed well in identifying MLH1 mutation carriers from the ACCFR and identified all cases of proven LS among the 1403 CRCs. Reflex BRAFV600E and MMR IHC are simple cheap tests that facilitate universal LS screening and identify the poor prognosis of the BRAFV600Emutant MSS CRC phenotype. Copyright © 2013 by Lippincott Williams & Wilkins.

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