Contralateral Breast Cancer Treatment With Germline Mutation Carriers

Siddartha Yadav, MD, FACP, assistant professor of oncology, senior associate consultant, Womens Oncology Program, at Mayo Clinic, discusses how to personalize treatment for patients with contralateral breast cancer, specifically in those with germline mutations.

Yadav's research is primarily focused on identifying genes and variants involved in susceptibility to cancers of the breast, ovaries, pancreas, and prostate using genetic epigenomics, epidemiologic, and functional studies, as well as characterizing the molecular biology and clinical outcomes of tumors with germline mutations in DNA repair genes.

"I believe [it] is very important because, you know, we can't just treat everybody the same, right? Because everybody is different and if you have a germline mutation that led to the breast or ovarian cancer, we know that those tumors are different compared to your regular breast or ovarian cancer," Yadav said. "I'm very proud and I feel privileged to be able to take care of these 5% to 10% of patients."

Yadav was motivated to conduct a study on contralateral breast cancer in patients with some of the germline mutations beyond BRCA1/2 and the risk of developing a second breast cancer.

"We know that [patients with] BRCA1/2, if they have first breast cancer, they are still at risk of developing second breast cancer and often will undergo bilateral mastectomies because of that. But that may not apply to ATM, CHEK2, PALB2, and people didn't just have data," Yadav explained in the interview. "You will hear from communities that a lot of women who are ATM, CHEK2, or PALB2 [positive] were undergoing bilateral mastectomy just because of that. And the lack of data, again, this goes to this whole concept of personalized medicine, right? If you don't have data, you can't really offer personalized medicine because now you can't tell these women what is your risk."