{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:00:47Z","timestamp":1784311247698,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer remains a leading cause of cancer-related morbidity and mortality globally, with BRCA1\/2 mutation carriers facing distinct challenges due to aggressive tumor biology and heightened risks of contralateral and secondary cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This review synthesizes evidence on managing early-stage breast cancer in BRCA mutation carriers, emphasizing Latin America\u2019s heterogeneous BRCA prevalence (ranging from 5% to 25.7% across countries), which underscores the need for region-specific genetic screening. BRCA-associated tumors exhibit homologous recombination deficiency, informing therapeutic strategies such as PARP inhibitors, which exploit synthetic lethality, as demonstrated by the OlympiA trial showing Olaparib\u2019s sustained survival benefits (28% reduction in mortality risk). Imaging strategies must adapt to BRCA-related tumor phenotypes: BRCA1 carriers often present mammography-elusive tumors, favoring MRI, while abbreviated MRI protocols offer cost-effective alternatives without compromising sensitivity. Surgical decision-making balances breast-conserving surgery (BCS) and mastectomy, with studies showing comparable survival outcomes but elevated contralateral cancer risk post-BCS (10-year risk: 14%), necessitating vigilant surveillance. Contralateral prophylactic mastectomy reduces contralateral cancer risk but requires personalized risk-benefit discussions. Neoadjuvant platinum-based chemotherapy shows higher pathologic complete response rates in BRCA carriers, particularly in triple-negative subtypes, though adjuvant platinum benefits remain under investigation. Emerging immunotherapies, such as pembrolizumab in KEYNOTE-522, show promise but lack BRCA-specific efficacy data. Special considerations for transgender BRCA carriers highlight evolving screening guidelines, including mammography for hormonally treated transgender women and multimodal imaging for non-mastectomized transgender men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Optimizing outcomes for BRCA mutation carriers demands multidisciplinary, personalized approaches integrating genetic, regional, and clinical factors. Advances in targeted therapies, refined imaging, and risk-adapted surgery emphasize the importance of shared decision-making and ongoing research to address knowledge gaps in survivorship and equitable care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748251377864","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T23:14:11Z","timestamp":1758323651000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Management in BRCA Carriers with Early Breast Cancer"],"prefix":"10.1177","volume":"32","author":[{"given":"Bruno","family":"Mu\u00f1ante","sequence":"first","affiliation":[{"name":"Oncosalud, AUNA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-8545","authenticated-orcid":false,"given":"Roberto","family":"Paz-Manrique","sequence":"additional","affiliation":[{"name":"Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2660-1843","authenticated-orcid":false,"given":"Henry L.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Oncosalud, AUNA, Lima, Peru"},{"name":"Universidad Peruana Cayetano Heredia, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S206949"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-020-01349-9"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05411-9"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.10814"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-021-00317-6"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-023-06892-5"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.25100\/cm.v48i2.1867"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2024.1683"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11091246"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-0980"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-015-3312-8"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1227864"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/cge.12505"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.7545954"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/378789a0"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s43587-021-00104-9"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trecan.2024.06.008"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4198-4"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2016.06.004"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers10120477"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjr\/tqae196"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021202927"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12123495"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2021.09.005"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jbi\/wbac095"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16030579"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-11756-1"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/BCTT.S395054"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.SABCS23-GS02-04"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-5999-8"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju160"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2016.12.002"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1599"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-020-05964-0"},{"key":"e_1_3_5_36_2","unstructured":"Lambertini M Sonnenblick A Agostinetto E et al. 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