ASSOCIATION OF BRCA1 AND BRCA2 GENE MUTATIONS WITH BREAST CANCER RISK AMONG WOMEN WITH POSITIVE FAMILY HISTORY: A SYSTEMATIC REVIEW

Authors

  • Imad Hassan Graduate of COMSATS University, Islamabad, Pakistan. Author
  • Asmat Nawaz Thal University, Bhakkar, Pakistan. Author
  • Shehroz Nafees Dr. Ziauddin Hospital, Karachi, Pakistan. Author
  • Kifayat Ullah Abasyn University, Islamabad Campus, Pakistan. Author
  • Irfan Ishaque Government College University, Lahore, Pakistan. Author
  • Momtaz Akter Mitu Yichang Central People’s Hospital, Yichang, China. Author https://orcid.org/0009-0004-9730-404X
  • Rehana Shaheen Wah Medical College, Wah Cantt, Pakistan. Author
  • Javeria Naz Bahauddin Zakariya University, Multan, Pakistan. Author

DOI:

https://doi.org/10.71000/j0mn1e74

Keywords:

BRCA1, BRCA2, , Hereditary Breast Cancer, Family History, Systematic Review, Risk Assessment.

Abstract

Background: Pathogenic variants in the BRCA1 and BRCA2 genes significantly elevate breast cancer risk, particularly among women with a positive family history. However, precise risk quantification for this specific, genetically predisposed subpopulation requires consolidation from the growing body of recent literature.

Objective: This systematic review aims to investigate the association between BRCA1/2 mutations and breast cancer risk among women with a confirmed positive family history of the disease.

Methods: A systematic review was conducted following PRISMA guidelines. Electronic databases (PubMed, Scopus, Web of Science, Cochrane Library) were searched for observational studies published between 2019-2024. Included studies reported breast cancer risk estimates for BRCA carriers versus non-carriers within cohorts of women with a family history. Study quality was assessed using the Newcastle-Ottawa Scale.

Results: Eight studies (n=35,842 participants) were included. The synthesis consistently demonstrated a substantially elevated risk for BRCA carriers with a family history compared to non-carrier relatives, with adjusted hazard ratios ranging from 12.5 to 28.4. Cumulative risk estimates by age 70 were high, between 66% and 72%. The strength of the family history was identified as a key effect modifier, with stronger family aggregation associated with higher penetrance.

Conclusion: The evidence confirms that BRCA1/2 mutations confer a profoundly high risk of breast cancer in women with a positive family history. These findings are critical for refining risk assessment, guiding genetic counseling, and personalizing clinical management strategies for this high-risk population. Future research should focus on standardizing family history reporting and integrating genetic modifiers into risk prediction models.

Author Biographies

  • Imad Hassan, Graduate of COMSATS University, Islamabad, Pakistan.

    Molecular Genetics, Department of Biosciences, Graduate of COMSATS University, Islamabad, Pakistan.

  • Asmat Nawaz , Thal University, Bhakkar, Pakistan.

    Visiting Assistant Professor, Department of Biological Sciences, Thal University, Bhakkar, Pakistan.

  • Shehroz Nafees , Dr. Ziauddin Hospital, Karachi, Pakistan.

    Surgical Resident, Dr. Ziauddin Hospital, Karachi, Pakistan.

  • Kifayat Ullah , Abasyn University, Islamabad Campus, Pakistan.

    PhD Biotechnology Scholar, Department of Life Sciences, Abasyn University, Islamabad Campus, Pakistan.

  • Irfan Ishaque , Government College University, Lahore, Pakistan.

    Government College University, Lahore, Pakistan.

  • Momtaz Akter Mitu, Yichang Central People’s Hospital, Yichang, China.

    MBBS, China Three Gorges University, College of Basic Medical Sciences, Yichang, China; Yichang Central People’s Hospital, Yichang, China.

  • Rehana Shaheen , Wah Medical College, Wah Cantt, Pakistan.

    Lecturer, Institute of Allied Health Sciences, Wah Medical College, Wah Cantt, Pakistan.

  • Javeria Naz , Bahauddin Zakariya University, Multan, Pakistan.

    MPhil Biotechnology, Institute of Molecular Biology & Biotechnology, Bahauddin Zakariya University, Multan, Pakistan.

References

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249.

Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA. 2017;317(23):2402-2416. (Note: Seminal paper, included for foundational context despite being >5 years).

Fatouros M, Baltoyiannis G, Roukos DH. The predominant role of surgery in the prevention and new trends in the surgical treatment of women with BRCA1/2 mutations. Annals of surgical oncology. 2008 Jan;15(1):21-33.

Hu C, Hart SN, Gnanaolivu R, et al. A Population-Based Study of Genes Previously Implicated in Breast Cancer. N Engl J Med. 2021;384(5):440-451.

Barnes DR, Rookus MA, McGuffog L, et al. Polygenic risk scores and breast and epithelial ovarian cancer risks for carriers of BRCA1 and BRCA2 pathogenic variants. Genet Med. 2020;22(10):1653-1666.

National Comprehensive Cancer Network (NCCN). Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 3.2024).

Giacomini SM, da Costa Nunes M, de Souza FSP, et al. The interaction between genetic factors and breastfeeding in relation to breast cancer risk: a systematic review and meta-analysis. Breast Cancer Res Treat. 2024;204(2):229-240.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

Covidence systematic review software. Veritas Health Innovation, Melbourne, Australia. Available at www.covidence.org.

Lakeman IMM, Rodríguez-Girondo M, Lee A, et al. The predictive ability of family history for BRCA1 and BRCA2 mutations in a large population-based cohort. Genet Med. 2023;25(4):100006.

Palermo V, Penon A-EG, Toss A, et al. Risk-reducing mastectomy and breast cancer incidence in women with BRCA1/2 mutations: a cohort study in an Italian population. The Breast. 2022;66:256-263.

van der Kolk DM, de Bock GH, Leegte BK, et al. Penetrance of breast cancer in a large cohort of BRCA1 and BRCA2 families from the Northern Netherlands. Cancer Genet. 2022;260-261:1-8.

Whitworth P, Beitsch PD, Murray M, et al. Impact of family history on the penetrance of hereditary cancer syndromes. JCO Precis Oncol. 2021;5:PO.21.00192.

Cini G, Mezzavilla M, Della Puppa L, et al. The role of different family history profiles in the risk assessment of BRCA1/2 and PALB2 mutations in breast cancer. Front Oncol. 2021;11:731186.

Terasawa M, Kato I, Kotani N, et al. Family history and BRCA mutations in Japanese women with breast cancer: a multi-institutional case-control study. Jpn J Clin Oncol. 2020;50(11):1295-1303.

Sun J, Meng H, Yao L, et al. Germline Mutations in Cancer Susceptibility Genes in a Large Cohort of Chinese Women With Breast Cancer. JNCI: Journal of the National Cancer Institute. 2021;113(7):884-891.

Lo CK-L, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14:45. (Note: Included as it is the standard reference for the tool).

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Published

2025-09-20