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Tengs, T.O. et al.

Tengs, Winer, Paddock, Aguilar-Chavez, Berry,

Testing for the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes: a decision analysis.

OBJECTIVE: The authors developed a Markov decision model to evaluate the health implications of testing for mutations in the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes. Prophylactic measures considered included various combinations of immediate and delayed bilateral mastectomy and oophorectomy or taking no action. METHODS: The model incorporated the likelihood of developing breast and/or ovarian cancer, survival, and quality of life. Parameter values were taken from public databases, the published literature, and a survey of cancer experts. Outcomes considered were additional life expectancy and quality-adjusted life years (QALYs). Results are reported for 30-year-old cancer-free women at various levels of hereditary risk. RESULTS AND CONCLUSIONS: The vast majority of women will not benefit from testing because their pre-test risks are low and surgical prophylaxis is undesirable. However, women who have family histories of early breast and/or ovarian cancer may gain up to 2 QALYs by allowing genetic testing to inform their decisions.[1]

References

Testing for the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes: a decision analysis. Tengs, T.O., Winer, E.P., Paddock, S., Aguilar-Chavez, O., Berry, D.A. Medical decision making : an international journal of the Society for Medical Decision Making. (1998) [Pubmed]

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