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臺灣醫學

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篇名 乳房的美麗與哀愁:從安潔莉娜裘莉談BRCA基因突變
卷期 19:6
並列篇名 The Beauty and the Sorrow of Breast: Angelina Jolie and BRCA Mutation
作者 吳宜芳陳怡君
頁次 631-635
關鍵字 安潔莉娜裘莉BRCA三陰性乳癌Angelina Jolietriple negative breast cancerTSCI
出刊日期 201511
DOI 10.6320/FJM.2015.19(6).11

中文摘要

女星安潔莉娜裘莉,因為有家族史及帶有BRCA1基因突變,於2013年接受預防性雙乳切除手術, 並在2015年接受預防性雙侧輸卵管及卵巢切除術。裘莉之所以如此決定,起因於多篇研究顯示有BRCA 1/2基因突變者,發生乳癌的機率高達87%,卵巢癌的機率高達60%。BRCA1/BRCA2基因被稱之為乳癌 易感基因第一型及第二型。它們分別位於第十七號染色體(BRCA1,17q21)和第十三號染色體上(BRCA2, 13q12-13)。主要的功能在製造蛋白質來修補被破壞的DNA。當BRCA1/BRCA2基因產生缺陷(即突變)時, 就容易產生癌變。不論國内外皆發現,有乳癌家族史者約有20-25%帶有BRCA1/BRCA2基因突變。其中 有BRCA1基因突變者,得到的常是三陰性乳癌(約佔1/3)。專家建議帶有基因突變者,在35-40歲期間預 防性切除雙乳,可減少約90%的乳癌發生率;若加做卵巢併輸卵管切除,約可減少80%的卵巢、輸卵管 癌發生率及50%的乳癌發生機率。本文將回顧BRCA帶原乳癌之病生理及目前的建議治療。

英文摘要

The famous American actress, Angelina Jolie underwent bilateral prophylactic mastectomy in 2013 because of her strong breast / ovarian cancer family history and the detection of a BRCA1 mutation. She also received prophylactic bilateral salpingo-oophrectomy (BSO) to prevent ovarian cancer in 2015. This is because the life risk of developing breast cancer and ovarian cancer in BRCA1/ 2 mutation carriers is as high as 87% and 60%. The BRCA1/ 2 genes, breast cancer susceptibility genes type 1 and 2, are located on chromosome XVII (BRCA1, 17q21) and XIII (BRCA2, 13q12-13). The normal function of BRCA1/ 2 is DNA repair and thus BRCA1/2 mutation results in tumorigenesis. A world-wide BRCA1/ BRCA2 mutation is detected in 20-25% of breast cancer patients with a family history and one third of BRCA1 mutation is associated with triple negative breast cancer. Prophylactic mastectomy at the age of 35 to 40 years would reduce 90% of breast cancer. Prophylactic BSO would reduce 80% of ovarian/ fallopian tube cancers and 50% of breast cancer. In this paper, we will review the pathophysiology of BRCA associated breast cancer and current management.

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