EUS-based pancreatic cancer surveillance in BRCA1/BRCA2/PALB2/ATM carriers without a family history of pancreatic cancer

Bryson W. Katona, Jessica M. Long, Nuzhat A. Ahmad, Sara Attalla, Angela R. Bradbury, Erica L. Carpenter, Dana F. Clark, Gillain Constantino, Koushik K. Das, Susan M. Domchek, Christina Dudzik, Jessica Ebrahimzadeh, Gregory G. Ginsberg, Jordan Heiman, Michael L. Kochman, Kara N. Maxwell, Danielle B. McKenna, Jacquelyn Powers, Payal D. Shah, Kirk J. WangensteenAnil K. Rustgi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Carriers of a pathogenic/likely pathogenic (P/LP) BRCA1/ BRCA2/ATM/PALB2 variant are at increased risk of pancreatic ductal adenocarcinoma (PDAC), yet current guidelines recommend surveillance only for those with a family history of PDAC. We aimed to investigate outcomes of endoscopic ultrasound (EUS)-based PDAC surveillance in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC. We performed a retrospective analysis of all P/LP BRCA1/BRCA2/ATM/PALB2 carriers who underwent EUS at a tertiary care center. Of 194 P/LP BRCA1/ BRCA2/ATM/PALB2 carriers who underwent EUS, 64 (33%) had no family history of PDAC and had at least 1 EUS for PDAC surveillance. These individuals underwent 143 total EUSs, were predominantly female (72%), and BRCA2 carriers (73%), with the majority having a personal history of cancer other than PDAC (67%). The median age at time of first EUS was 62 years [interquartile range (IQR), 53-67 years] and a median of 2 EUSs (IQR 1-3) were performed per patient, with a median of 3 years (IQR 2-4.5 years) between the first and last EUS for those with more than 1 EUS. Pancreatic abnormalities were detected in 44%, including cysts in 27%, and incidental luminal abnormalities in 41%. Eight percent developed a new pancreatic mass or cyst during surveillance, 2 individuals developed PDAC, and no serious complications resulted from surveillance. After discussion of the risks, limitations, and potential benefits, PDAC surveillance can be considered in BRCA1/BRCA2/ATM/PALB2 carriers without a family history of PDAC; however, the effectiveness of PDAC surveillance in this population requires further study.

Original languageEnglish
Pages (from-to)1033-1040
Number of pages8
JournalCancer Prevention Research
Volume14
Issue number11
DOIs
StatePublished - Nov 2021

Fingerprint

Dive into the research topics of 'EUS-based pancreatic cancer surveillance in BRCA1/BRCA2/PALB2/ATM carriers without a family history of pancreatic cancer'. Together they form a unique fingerprint.

Cite this