Risk of late-onset breast cancer in genetically predisposed women

A study including 26,707 women over age 65 years (51.5% with breast cancer and 48.5% unaffected) found PVs in breast cancer predisposition genes in 3.18% of patients and 1.48% of unaffected women. PVs in BRCA1, BRCA2, and PALB2 were found in 3.42% of women with ER-negative disease, 1.0% with ER-positive disease, and 3.01% with TNBC. PVs in CHEK2, PALB2, BRCA1, and BRCA2were associated with increased risk of breast cancer (ORs 2.9-4.0). Remaining lifetime risks of breast cancerwere ≥ 15% for those with PVs in BRCA1, BRCA2, and PALB2. The authors conclude that all women diagnosed with TNBC or ER-negative breast cancer should be offered genetic testing, and that women over age 65 years with BRCA1 and BRCA2 PVs, and perhaps with PALB2 and CHEK2 PVs should be considered for MRI screening.