{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:33:44Z","timestamp":1791016424196,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2004,6,23]],"date-time":"2004-06-23T00:00:00Z","timestamp":1087948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2004,11,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of our study was to review the evidence for the efficacy of surveillance for early detection, bilateral prophylactic mastectomy, prophylactic oophorectomy and chemoprevention in preventing breast cancer and improving survival of <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> carriers. A critical review of journal articles published between 1998 and 2004 identified by searches of MEDLINE, PubMed and references of retrieved articles was undertaken. None of the current evidence is based on randomized studies. The efficacy of surveillance for early detection of breast cancer among <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> carriers is not yet established. Screening with clinical breast examination and mammography showed lower sensitivity in <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> carriers than in the general population. Screening with MRI might offer higher sensitivity rates than mammography. Prophylactic mastectomy was shown to significantly reduce the risk of breast cancer by 89.5\u2013100%. However, of all strategies reviewed, mastectomy was the least acceptable to women at high risk. Tamoxifen use was associated with breast cancer prevention among <jats:italic>BRCA2<\/jats:italic> carriers (RR=0.38, 95%CI: 0.06\u20131.56). In <jats:italic>BRCA1<\/jats:italic> or <jats:italic>BRCA2<\/jats:italic> carriers with breast cancer, tamoxifen use was associated with the prevention of secondary breast cancer (OR= 0.50, 95% CI: 0.28\u20130.89). Prophylactic oophorectomy was associated with hazard ratios for breast cancer of 0.47 (95%CI:0.29\u20130.77) and 0.32 (95%CI: 0.08\u20131.20), in retrospective and short follow\u2010up prospective cohort studies, respectively. There is a pressing need for more studies in order to determine which of the 4 strategies alone, or in combination, is the most effective for the prevention of breast cancer and for the improvement of survival of <jats:italic>BRCA<\/jats:italic> mutation carriers. \u00a9 2004 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ijc.20429","type":"journal-article","created":{"date-parts":[[2004,6,23]],"date-time":"2004-06-23T16:02:35Z","timestamp":1088006555000},"page":"357-364","source":"Crossref","is-referenced-by-count":73,"title":["Prevention of breast cancer in women who carry <i>BRCA1<\/i> or <i>BRCA2<\/i> mutations: A critical review of the 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