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Review
. 2024 Sep 11;150(9):417.
doi: 10.1007/s00432-024-05936-7.

The risk of endocrine interventions in carriers of a genetic predisposition for breast and gynecologic cancers: recommendations of the German Consortium for Hereditary Breast and Ovarian Cancer

O Ortmann  1 , S Schüler-Toprak  2 , K Kast  3 ; working group “Hormones”, The German Consortium for Hereditary Breast, Ovarian Cancer (GC-HBOC)
Collaborators, Affiliations
Review

The risk of endocrine interventions in carriers of a genetic predisposition for breast and gynecologic cancers: recommendations of the German Consortium for Hereditary Breast and Ovarian Cancer

O Ortmann et al. J Cancer Res Clin Oncol. .

Abstract

Purpose: To support doctors in counselling women with genetic predisposition for breast or gynecologic cancers on endocrine interventions.

Methods: Evidence on the safety of endocrine interventions for fertility treatment, contraception, hormone replacement therapy after risk-reducing salpingo-oophorectomy (RRSO) or treatment of symptoms during peri- and postmenopause was analysed for carriers of probably pathogenic and pathogenic variants in BRCA1 or BRCA2 (BRCA1/2-pV), in other breast and ovarian cancer genes and the Lynch Syndrome. Cancer risks were compared with data on risks for the general population.

Results: Data on risk modulation of endocrine interventions in women with genetic predisposition is limited. Ovarian hyperstimulation for fertility treatment may be performed. Oral contraceptives should not be used to reduce ovarian cancer risk in BRCA1/2-pV carriers. Premenopausal BRCA1/2-pV carriers and carriers of pV in Lynch Syndrome genes should be offered hormone replacement therapy (HRT) after RRSO, to prevent diseases caused by estrogen deficiency.

Conclusion: Effect direction and strength of risk modulation by endocrine interventions is similar to the general population. Participation of individuals at risk in prospective registries is recommended.

Keywords: BRCA1 and BRCA2; Breast cancer; Fertility treatment; Hormone therapy; Oral contraception; Ovarian cancer.

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Conflict of interest statement

Financial interests: O.O.: O.O. has received speaker honorarium from AstraZeneca; Astellas Pharma; Novartis Pharma and ownes stocks of Novartis, Bayer, Fresenius Medical Care, Curevac, Morphosys S.S.-T.: SST received speaker honorarium from Pfizer, Roche and author honorarium from thieme and further training was supported by GSK and Celgene K.K.: Honorary, advisory board, Pfizer Pharma Non-financial interests: O.O.: Memberships: Member of the Board of the German Cancer Society, Board of Trustees of German Cancer Aid, Member of the Board of ADT; Memberships of professional associations: German Society for Gynecology and Obstetrics—Gynecological Oncology Working Group, Kommission OVAR; German Society for Senology; German Society for Endocrinology; Working Group for Gynecologic Oncology; German Cancer Society; Bavarian Cancer Society; Bavarian Society for Obstetrics and Gynecology; Coordinator of the S3 guideline “Peri- and Postmenopause—Diagnostics and Interventions”; Mandate holder for the DKG Certification Commission for Gynecological Cancer Centers S.S.-T.: SST is Member of the Working Group for Cervical Pathology and Colposcopy (AG-CPC); Member of the German Society for Gynecology and Obstetrics (DGGG); Member of the Working Group for Gynecologic Oncology (AGO) and the Kommission OVAR and Member of the German Cancer Society (DKG) K.K.: none.

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