Management of Hereditary Breast Cancer

2021 UPDATED RECOMMENDATION

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  For patients with early-stage, HER2-negative breast cancer with high risk of recurrence and germline BRCA1 or BRCA2 pathogenic or likely pathogenic variants, one year of adjuvant olaparib should be offered after completion of (neo)adjuvant chemotherapy and local treatment, including radiation. For those who had surgery first, 1 year of adjuvant olaparib should be offered for patients with triple-negative breast cancer and tumor size > 2 cm or any involved axillary nodes. For those with hormone receptor–positive disease, 1 year of adjuvant olaparib should be offered to those with at least four involved axillary lymph nodes. For patients who had neo-adjuvant chemotherapy, 1 year of adjuvant olaparib should be offered to patients with triple-negative breast cancer and any residual cancer; for patients with hormone receptor–positive disease, 1 year of adjuvant olaparib should be offered to patients with residual disease and a clinical stage, pathologic stage, estrogen receptor, and tumor grade score >= 3.

  Adjuvant Therapy

Therapeutic Area

Guideline Scope

Inclusion Criteria

• Early-stage, HER2-negative breast cancer
• High risk of recurrence
• Germline BRCA1 or BRCA2 pathogenic or likely pathogenic variants
• Completed local treatment and at least six cycles of (neo)adjuvant chemotherapy

Special Populations

Related

• Management of hereditary breast cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline (2020)