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The impact of a BRCA2 mutation on mortality from screen-detected prostate cancer.

Akbari MR, Wallis CJ, Toi A, Trachtenberg J, Sun P, Narod SA, Nam RK.

Br J Cancer. 2014 Aug 7. [Epub ahead of print]

Comment from Henk van der Poel:
BRCA2 carriers not only have an increased risk of prostate cancer but also worse prognosis when detected in a screening program.

Abstract

Background:

Men with a BRCA2 mutation face an increased risk of prostate cancer. These cancers tend to have an aggressive nature and it has not yet been demonstrated that regular screening of BRCA2 carriers is associated with improved survival.

Methods:

We identified 4187 men who underwent a prostate cancer biopsy for an elevated PSA or an abnormal digital rectal examination between 1998 and 2010. We screened the BRCA2 gene in its entirety for mutations and we followed the men for death from prostate cancer until December 2012.

Results:

The 12-year prostate cancer-specific survival rate was 94.3% for men without a BRCA2 mutation and was 61.8% for men with a mutation (P<10-4; log-rank test).

Conclusions:

The survival of men with screen-detected prostate cancer and a BRCA2 mutation is much poorer than expected.

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