EUS-based Pancreatic Cancer Surveillance in BRCA1/BRCA2/PALB2/ATM Carriers Without a Family History of Pancreatic Cancer.
EUS-based Pancreatic Cancer Surveillance in BRCA1/BRCA2/PALB2/ATM Carriers Without a Family History of Pancreatic Cancer.
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DOI：
10.1158/1940-6207.capr-21-0161
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发表时间：
2021-11
期刊：
影响因子：
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通讯作者：
Rustgi AK
中科院分区：
文献类型：
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作者：
Katona BW;Long JM;Ahmad NA;Attalla S;Bradbury AR;Carpenter EL;Clark DF;Constantino G;Das KK;Domchek SM;Dudzik C;Ebrahimzadeh J;Ginsberg GG;Heiman J;Kochman ML;Maxwell KN;McKenna DB;Powers J;Shah PD;Wangensteen KJ;Rustgi AK
Carriers of a pathogenic/likely pathogenic (P/LP) BRCA1/BRCA2/ATM/PALB2 variant are at increased risk of pancreatic ductal adenocarcinoma (PDAC), yet current guidelines recommend surveillance only for those with a family history of PDAC. We aimed to investigate outcomes of endoscopic ultrasound (EUS)-based PDAC surveillance in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC. We performed a retrospective analysis of all P/LP BRCA1/BRCA2/ATM/PALB2 carriers who underwent endoscopic ultrasound (EUS) at a tertiary care center. Of 194 P/LP BRCA1/BRCA2/ATM/PALB2 carriers who underwent EUS, 64 (33%) had no family history of PDAC and had at least one EUS for PDAC surveillance. These individuals underwent 143 total EUSs, were predominantly female (72%) and BRCA2 carriers (73%), with the majority having a personal history of cancer other than PDAC (67%). The median age at time of first EUS was 62 years (IQR 53–67 years) and a median of 2 EUSs (IQR 1–3) were performed per patient, with a median of 3 years (IQR 2–4.5 years) between the first and last EUS for those with more than 1 EUS. Pancreatic abnormalities were detected in 44%, including cysts in 27%, and incidental luminal abnormalities in 41%. Eight percent developed a new pancreatic mass or cyst during surveillance, two individuals developed PDAC, and no serious complications resulted from surveillance. After discussion of the risks, limitations, and potential benefits, PDAC surveillance can be considered in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC, however the effectiveness of PDAC surveillance in this population requires further study.
