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It evaluates imaging approaches, risk-adapted surgery, platinum-based chemotherapy, and emerging targeted and immune strategies, including survivorship and equity considerations for personalized multidisciplinary care.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/clinical-management-in-brca-carriers-with-early-breast-cancer/370920/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/clinical-management-in-brca-carriers-with-early-breast-cancer/370920.png","ImageObject",300,407,{"name":42,"@type":43},"Aldword","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-31","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What makes BRCA mutation carriers different in early breast cancer management?","Question",{"text":63,"@type":64},"BRCA1/2 carriers face distinct challenges due to aggressive tumor biology and heightened risks of contralateral and secondary cancers, with BRCA-associated tumors showing homologous recombination deficiency.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should imaging be adapted for BRCA1 versus other BRCA-related tumor phenotypes?",{"text":68,"@type":64},"BRCA1 carriers often present mammography-elusive tumors, making MRI preferred; abbreviated MRI protocols can provide cost-effective options without compromising sensitivity.",{"name":70,"@type":61,"acceptedAnswer":71},"How do surgery options compare for BRCA carriers, and what additional risks should be discussed?",{"text":72,"@type":64},"Breast-conserving surgery and mastectomy show comparable survival outcomes, but breast-conserving surgery carries a higher 10-year contralateral cancer risk (14%). Contralateral prophylactic mastectomy lowers that risk and requires personalized risk-benefit discussions.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},370920,1790241605,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","| Clinical Management in BRCA Carriers with Early Breast Cancer | Cancer Control Volume 32: 1-13 © The Author(s) 2025 Article reuse guidelines:\u003Cbr>[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/10732748251377864](DOI: 10.1177/10732748251377864)\u003Cbr>[journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx)\u003Cbr>\u003Cbr>|\n| --- | --- |\n| Bruno Muñante, MD 1, Roberto Paz-Manrique, MD2 􀀁 ,\u003Cbr>Joseph A. Pinto, MPH3, and Henry L. Gomez, MD, MSc, PhD 1,4 􀀁\u003Cbr>Abstract\u003Cbr>Background: 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.\u003Cbr>Purpose: This review synthesizes evidence on managing early-stage breast cancer in BRCA mutation carriers, emphasizing Latin America’s 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’s 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-specificefficacy 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. Conclusions: 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.\u003Cbr>Keywords\u003Cbr>BRCA, breast cancer, surgery, systemic treatment, cancer, management\u003Cbr>Received: June 2, 2025; revised: July 31, 2025; accepted: August 26, 2025. |  |\n| 1 Oncosalud, AUNA, Lima, Peru\u003Cbr>2Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru 3Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru\u003Cbr>4Universidad Peruana Cayetano Heredia, Lima, Peru\u003Cbr>Corresponding Author:\u003Cbr>Roberto Paz-Manrique, MD, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru.\u003Cbr>Email: [robertopazm@hotmail.com](robertopazm@hotmail.com) |  |\n\nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons  \nAttribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use,  \nreproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sage","cbCaicf90wGYodp0","https://ap.wps.com/l/cbCaicf90wGYodp0","pdf",1043082,13,"English","# Abstract\n## Background and Purpose\n## Risk-Adapted Treatment Strategies","[{\"question\":\"What makes BRCA mutation carriers different in early breast cancer management?\",\"answer\":\"BRCA1/2 carriers face distinct challenges due to aggressive tumor biology and heightened risks of contralateral and secondary cancers, with BRCA-associated tumors showing homologous recombination deficiency.\"},{\"question\":\"How should imaging be adapted for BRCA1 versus other BRCA-related tumor phenotypes?\",\"answer\":\"BRCA1 carriers often present mammography-elusive tumors, making MRI preferred; abbreviated MRI protocols can provide cost-effective options without compromising sensitivity.\"},{\"question\":\"How do surgery options compare for BRCA carriers, and what additional risks should be discussed?\",\"answer\":\"Breast-conserving surgery and mastectomy show comparable survival outcomes, but breast-conserving surgery carries a higher 10-year contralateral cancer risk (14%). Contralateral prophylactic mastectomy lowers that risk and requires personalized risk-benefit discussions.\"}]","Clinical Management in BRCA Carriers with Early Breast Cancer | PDF",1790190829,33]