Abstract A029: Breast Cancer Screening During Reproductive Years in Women with Germline Pathogenic Variants: Gaps in Counseling and Practice
Notice bibliographique
Résumé
Abstract Detection of germline pathogenic Variants (PVs) in BRCA1, BRCA2, and other genes that significantly elevate lifetime breast cancer (BC) risk are indications for early initiation of intensive screening. BRCA1/2 PVs guidelines recommend that magnetic resonance imaging (MRI) screening begin at age 25 and mammography screening at age 30. However, pregnancy, breastfeeding, and the postpartum period may complicate adherence due to patient concerns about MRI contrast, radiation exposure, logistical barriers, and limited guidance on timing. The incidence of BC peaks approximately 5 years postpartum, especially among women with a positive family history, and early-onset cancers are frequently aggressive, exacerbating the effects of delayed detection. We assessed screening and counseling practices during reproductive periods among women with or at risk for PVs to identify knowledge gaps and opportunities to improve surveillance. We conducted an anonymous survey from March 2023 through January 2025 distributed by Facing Our Risk of Cancer Empowered (FORCE) and social media platforms. Data were collected through a secure REDCap instrument and summarized with descriptive statistics and logistic regression. The Mayo Clinic Institutional Review Board deemed the study exempt. Among the 537 respondents (median age 43 years; 88.5% U.S. residents; 87.5% White), 66.2% were parous and 61.8% knew their family history of BC during pregnancy. Most women reported receiving counseling on screening breast examination, mammography, and MRI; however, 74-77% received no specific guidance about screening before, during, or after pregnancy and weaning. At the time of the survey, 89.9% had undergone BC screening, including 66.2% with annual mammography and 53.1% with annual MRI. Yet during pregnancy and breastfeeding, 69% reported not being screened. Parous women were more likely than nulliparous women to report screening (96.9% vs 85.6%,p<0.0001) and regular mammography (76.4% vs 57.2%,p<0.0001). Screening during pregnancy and breastfeeding was more common among the BRCA1/2 carriers than among carriers of other PVs. Breastfeeding affected screening behavior in 32% of the BRCA1/2 carriers versus 10.9% of other PV carriers, yet only 5.1% of PV carriers stopped breastfeeding to undergo imaging. After their last birth, many women postponed screenings for more than 3 years and only 20.5% received a mammogram within a year of their delivery. Overall, 28.8% of participants reported a history of cancer, of which 66.2% was BC. Approximately 20% of breast cancers reported were diagnosed within 3 years postpartum, with 8.6% occurring during lactation. Despite high rates of BC screening, most high-risk women received little counseling about imaging during pregnancy and breastfeeding, potentially contributing to delayed surveillance at a time of heightened BC risk. These findings highlight the need for targeted counseling, scheduling strategies to support MRI or other imaging during and after pregnancy, and development of novel early-detection tools such as blood or breastmilk biomarkers. Citation Format: Laura M. Pacheco-Spann, Sue Friedman, Diane Rose, William D. Foulkes, Zhihui Fang, Lauren E. Haydu, Mark E. Sherman. Breast Cancer Screening During Reproductive Years in Women with Germline Pathogenic Variants: Gaps in Counseling and Practice [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr A029.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».