Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)

Breast cancer remains one of the frequently diagnosed malignant tumors among Chinese women, with hereditary cases accounting for 5%-10% of all diagnoses, where BRCA1/2 gene mutations serve as the primary genetic predisposition factors. Although targeted therapies like poly (ADP-ribose) polymerase (P...

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Main Author: WANG Hongxia, YIN Yongmei, HU Xichun
Format: Article
Language:English
Published: Editorial Office of China Oncology 2025-07-01
Series:Zhongguo aizheng zazhi
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Online Access:https://www.china-oncology.com/fileup/1007-3639/PDF/1755061437231-1222886985.pdf
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author WANG Hongxia, YIN Yongmei, HU Xichun
author_facet WANG Hongxia, YIN Yongmei, HU Xichun
author_sort WANG Hongxia, YIN Yongmei, HU Xichun
collection DOAJ
description Breast cancer remains one of the frequently diagnosed malignant tumors among Chinese women, with hereditary cases accounting for 5%-10% of all diagnoses, where BRCA1/2 gene mutations serve as the primary genetic predisposition factors. Although targeted therapies like poly (ADP-ribose) polymerase (PARP) inhibitors have significantly improved prognoses for patients with BRCA-mutated breast cancer in recent years, critical clinical challenges persist, including the standardization of genetic testing protocols, optimization of precision treatment approaches, and refinement of long-term management strategies. In response to these challenges, our expert panel has conducted a comprehensive update to the 2018 Edition of this consensus by integrating the latest global evidence-based medical research with China’s unique clinical practice characteristics. This 2025 Edition provides systematic evaluations and recommendations on five key aspects: indications for BRCA1/2 gene testing, testing methodologies, result interpretation, treatment strategies, and risk management. The main updates include: ① Increasing the relationship between BRCA1/2 gene mutations and programmed death ligand-1 (PD-L1) expression, as well as related content on BRCAness types; ② Standardizing the application of genetic testing, such as increasing the significance, timing, and sample selection of clinical testing, and optimizing the BRCA testing population; ③ Updating treatment strategies, such as non-drug treatment of BRCA1/2 gene mutation, treatment of triple negative breast cancer (TNBC) patients with BRCA1/2 gene mutation, treatment decisions of hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)- breast cancer patients with BRCA1/2 gene mutation, clinical use of PARP inhibitors and adverse reaction management; ④ Addion of relevant content on long-term risk management, such as covering follow-up management, indications for preventive surgery, quality control and requirements for new genetic testing, updating genetic testing processes, report content and interpretation. This consensus aimed to establish standardized diagnostic and therapeutic frameworks for clinicians, advance precision medicine in BRCA-mutated breast cancer, and ultimately improve patient survival outcomes. As new evidence emerges, continuous updates will be implemented to incorporate the latest research findings. This consensus has been registered on the Practice guideline REgistration for transPAREncy (PREPARE) platform (registration number: PREPARE-2025CN1085).
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spelling doaj-art-eefc05597f114f919b6c545bf952e1932025-08-20T03:36:35ZengEditorial Office of China OncologyZhongguo aizheng zazhi1007-36392025-07-0135771073410.19401/j.cnki.1007-3639.2025.07.010Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)WANG Hongxia, YIN Yongmei, HU Xichun0Committee of Breast Cancer Society, Chinese Anti-Cancer Association; Clinical Precision Medicine Professional Committee, Chinese Medical Doctor Association; Tumor Heterogeneity and Personalized Therapy Professional Committee, Chinese Anti-Cancer AssociationBreast cancer remains one of the frequently diagnosed malignant tumors among Chinese women, with hereditary cases accounting for 5%-10% of all diagnoses, where BRCA1/2 gene mutations serve as the primary genetic predisposition factors. Although targeted therapies like poly (ADP-ribose) polymerase (PARP) inhibitors have significantly improved prognoses for patients with BRCA-mutated breast cancer in recent years, critical clinical challenges persist, including the standardization of genetic testing protocols, optimization of precision treatment approaches, and refinement of long-term management strategies. In response to these challenges, our expert panel has conducted a comprehensive update to the 2018 Edition of this consensus by integrating the latest global evidence-based medical research with China’s unique clinical practice characteristics. This 2025 Edition provides systematic evaluations and recommendations on five key aspects: indications for BRCA1/2 gene testing, testing methodologies, result interpretation, treatment strategies, and risk management. The main updates include: ① Increasing the relationship between BRCA1/2 gene mutations and programmed death ligand-1 (PD-L1) expression, as well as related content on BRCAness types; ② Standardizing the application of genetic testing, such as increasing the significance, timing, and sample selection of clinical testing, and optimizing the BRCA testing population; ③ Updating treatment strategies, such as non-drug treatment of BRCA1/2 gene mutation, treatment of triple negative breast cancer (TNBC) patients with BRCA1/2 gene mutation, treatment decisions of hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)- breast cancer patients with BRCA1/2 gene mutation, clinical use of PARP inhibitors and adverse reaction management; ④ Addion of relevant content on long-term risk management, such as covering follow-up management, indications for preventive surgery, quality control and requirements for new genetic testing, updating genetic testing processes, report content and interpretation. This consensus aimed to establish standardized diagnostic and therapeutic frameworks for clinicians, advance precision medicine in BRCA-mutated breast cancer, and ultimately improve patient survival outcomes. As new evidence emerges, continuous updates will be implemented to incorporate the latest research findings. This consensus has been registered on the Practice guideline REgistration for transPAREncy (PREPARE) platform (registration number: PREPARE-2025CN1085).https://www.china-oncology.com/fileup/1007-3639/PDF/1755061437231-1222886985.pdf|breast cancer|brca1/2 gene|therapy|prevention|detection|consensus
spellingShingle WANG Hongxia, YIN Yongmei, HU Xichun
Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
Zhongguo aizheng zazhi
|breast cancer|brca1/2 gene|therapy|prevention|detection|consensus
title Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
title_full Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
title_fullStr Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
title_full_unstemmed Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
title_short Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients (2025 edition)
title_sort expert consensus on brca1 2 gene testing and clinical application in chinese breast cancer patients 2025 edition
topic |breast cancer|brca1/2 gene|therapy|prevention|detection|consensus
url https://www.china-oncology.com/fileup/1007-3639/PDF/1755061437231-1222886985.pdf
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