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Cancer Risks Associated With Germline PALB2 Pathogenic Variants: An International Study of 524 Families

X. Yang, G. Leslie, A. Doroszuk, S. Schneider, J. Allen, B. Decker, AM. Dunning, J. Redman, J. Scarth, I. Plaskocinska, C. Luccarini, M. Shah, K. Pooley, L. Dorling, A. Lee, MA. Adank, J. Adlard, K. Aittomäki, IL. Andrulis, P. Ang, J. Barwell,...

. 2020 ; 38 (7) : 674-685. [pub] 20191216

Language English Country United States

Document type Journal Article, Research Support, Non-U.S. Gov't

Grant support
203477/Z/16/Z Wellcome Trust - United Kingdom
P30 CA008748 NCI NIH HHS - United States
R01 ES027121 NIEHS NIH HHS - United States
K08 CA234394 NCI NIH HHS - United States
L60 MD014321 NIMHD NIH HHS - United States
10124 Cancer Research UK - United Kingdom
NV16-29959A MZ0 CEP Register

PURPOSE: To estimate age-specific relative and absolute cancer risks of breast cancer and to estimate risks of ovarian, pancreatic, male breast, prostate, and colorectal cancers associated with germline PALB2 pathogenic variants (PVs) because these risks have not been extensively characterized. METHODS: We analyzed data from 524 families with PALB2 PVs from 21 countries. Complex segregation analysis was used to estimate relative risks (RRs; relative to country-specific population incidences) and absolute risks of cancers. The models allowed for residual familial aggregation of breast and ovarian cancer and were adjusted for the family-specific ascertainment schemes. RESULTS: We found associations between PALB2 PVs and risk of female breast cancer (RR, 7.18; 95% CI, 5.82 to 8.85; P = 6.5 × 10-76), ovarian cancer (RR, 2.91; 95% CI, 1.40 to 6.04; P = 4.1 × 10-3), pancreatic cancer (RR, 2.37; 95% CI, 1.24 to 4.50; P = 8.7 × 10-3), and male breast cancer (RR, 7.34; 95% CI, 1.28 to 42.18; P = 2.6 × 10-2). There was no evidence for increased risks of prostate or colorectal cancer. The breast cancer RRs declined with age (P for trend = 2.0 × 10-3). After adjusting for family ascertainment, breast cancer risk estimates on the basis of multiple case families were similar to the estimates from families ascertained through population-based studies (P for difference = .41). On the basis of the combined data, the estimated risks to age 80 years were 53% (95% CI, 44% to 63%) for female breast cancer, 5% (95% CI, 2% to 10%) for ovarian cancer, 2%-3% (95% CI females, 1% to 4%; 95% CI males, 2% to 5%) for pancreatic cancer, and 1% (95% CI, 0.2% to 5%) for male breast cancer. CONCLUSION: These results confirm PALB2 as a major breast cancer susceptibility gene and establish substantial associations between germline PALB2 PVs and ovarian, pancreatic, and male breast cancers. These findings will facilitate incorporation of PALB2 into risk prediction models and optimize the clinical cancer risk management of PALB2 PV carriers.

Ambry Genetics Aliso Viejo CA

Ambry Genetics Aliso Viejo CA Department of Epidemiology University of California Irvine Irvine CA

Biopathologie Centre Léon Bérard Lyon France

Cancer Research Malaysia Subang Jaya Selangor Malaysia

Center for Clinical Cancer Genetics The University of Chicago Chicago IL

Center for Molecular Medicine Cologne University of Cologne Cologne Germany Center for Hereditary Breast and Ovarian Cancer University Hospital of Cologne Cologne Germany

Centre for Cancer Genetic Epidemiology Department of Oncology University of Cambridge Cambridge United Kingdom

Centre for Cancer Genetic Epidemiology Department of Public Health and Primary Care University of Cambridge Cambridge United Kingdom

Centre for Cancer Genetic Epidemiology Department of Public Health and Primary Care University of Cambridge Cambridge United Kingdom Cancer Genetics Branch National Human Genome Research Institute National Institutes of Health Bethesda MD Department of Pathology Brigham and Women's Hospital Boston MA

Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia

Centre for Medical Genetics Ghent University Ghent Belgium

City of Hope National Medical Center Duarte CA

Clinical Cancer Genomics Community Research Network City of Hope Duarte CA

Clinical Cancer Genomics Community Research Network City of Hope Duarte CA Department of Medical Oncology Division of Clinical Cancer Genomics City of Hope Duarte CA

Department of Clinical Genetics Aarhus University Hospital Aarhus Denmark

Department of Clinical Genetics and Pathology Department of Laboratory Medicine Office for Medical Services Lund Sweden Division of Clinical Genetics Department of Laboratory Medicine Lund University Lund Sweden

Department of Clinical Genetics Helsinki University Hospital University of Helsinki Helsinki Finland

Department of Clinical Genetics Oulu University Hospital Medical Research Center Oulu and PEDEGO Research Unit University of Oulu Oulu Finland

Department of Clinical Genetics Rigshospitalet Copenhagen University Hospital Copenhagen Denmark Center for Genomic Medicine Rigshospitalet Copenhagen University Hospital Copenhagen Denmark

Department of Clinical Pathology The University of Melbourne Melbourne Victoria Australia Precision Medicine School of Clinical Sciences at Monash Health Monash University Clayton Victoria Australia

Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York NY

Department of Genetics and Computational Biology QIMR Berghofer Medical Research Institute Brisbane Queensland Australia

Department of Genetics Centre Hospitalier de l'Université de Montréal Montreal Quebec Canada

Department of Genetics University of MiamiMiller School of Medicine Miami FL

Department of Gynecology and Obstetrics Ludwig Maximilians University of Munich Munich Germany

Department of Health Sciences Research Mayo Clinic Rochester MN

Department of Human Genetics Hannover Medical School Hannover Germany

Department of Medical Genetics NIHR Cambridge Biomedical Research Centre and Cancer Research UK Cambridge Centre University of Cambridge Cambridge United Kingdom

Department of Molecular Medicine University La Sapienza Rome Italy

Department of Obstetrics and Gynecology Helsinki University Hospital University of Helsinki Helsinki Finland

Department of Obstetrics Gynecology and Reproductive Sciences Division of Gynecologic Oncology Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami FL

Department of Oncology Helsinki University Hospital University of Helsinki Helsinki Finland

Department of Population Sciences Beckman Research Institute City of Hope Duarte CA

Department ofMedicine Abramson Cancer Center Perelman School of Medicine University of Pennsylvania Philadelphia PA

Department ofMedicine Abramson Cancer Center Perelman School of Medicine University of Pennsylvania Philadelphia PA Prospective Registry of Multiplex Testing United States and Europe

Division of Evolution and Genomic Sciences University of Manchester

Division of Medical Oncology Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami FL

Division of Oncology and Pathology Department of Clinical Sciences Lund Lund University Lund Sweden

Familial Cancer Program The University of Vermont Cancer Center Burlington VT

Family Cancer Clinic The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital Amsterdam the Netherlands

Genome Diagnostics Program IFOM The FIRC Institute for Molecular Oncology Milan Italy

Hematology Oncology and Transfusion Medicine Center Department of Molecular and Regenerative Medicine Vilnius University Hospital Santariskiu Clinics Vilnius Lithuania

Hematology Oncology and Transfusion Medicine Center Department of Molecular and Regenerative Medicine Vilnius University Hospital Santariskiu Clinics Vilnius Lithuania State Research Institute Innovative Medicine Center Vilnius Lithuania

Huntsman Cancer Institute Department of Population Health Sciences University of Utah Salt Lake City UT

INSERM U900 Institut Curie PSL University Mines ParisTech Paris France

Institute for Medical Informatics Statistics and Epidemiology University of Leipzig Leipzig Germany

Institute of Biochemistry and Experimental Oncology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Institute of Biochemistry and Experimental Oncology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic Institute of Biology and Medical Genetics 1st Faculty of Medicine Charles University Prague Czech Republic

Institute of Clinical Medicine Pathology and Forensic Medicine University of Eastern Finland Kuopio Finland

Institute of Medical Genetics Kepler University Hospital Linz and Laboratory for Molecular Biology and Tumor Cytogenetics Ordensklinikum Linz Linz Austria

Keck School of Medicine University of Southern California Norris Comprehensive Cancer Center Los Angeles CA

Laboratory of Cancer Genetics and Tumor Biology Cancer and Translational Medicine Research Unit Biocenter Oulu University of Oulu and Northern Finland Laboratory Centre Oulu Finland

Laboratory of Molecular Oncology Division of Cellular and Molecular Research National Cancer Centre Singapore Singapore

Lawrence S Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada

Leicestershire Clinical Genetics Service University Hospitals of Leicester NHS Trust Leicester United Kingdom

Leicestershire Clinical Genetics Service University Hospitals of Leicester NHS Trust Leicester United Kingdom Department of Physiology Yong Loo Lin School of Medicine National University of Singapore Singapore SingHealth Duke NUS Oncology Academic Clinical Programme Duke NUS Medical School Singapore

Lunenfeld Tanenbaum Research Institute of Mount Sinai Hospital Toronto Ontario Canada

Manchester Academic Health Science Centre Manchester United Kingdom

Manchester Centre for Genomic Medicine St Mary's Hospital Manchester University Hospitals NHS Foundation Trust

Molecular Diagnostics Laboratory INRASTES National Centre for Scientific Research Demokritos Athens Greece

Oncogenetics Group Clinical and Molecular Genetics Area Vall d'Hebron Institute of Oncology United States and Europe

Oncogenetics Group Clinical and Molecular Genetics Area Vall d'Hebron Institute of Oncology University Hospital Vall d'Hebron Barcelona Spain

Prospective Registry of Multiplex Testing United States and Europe Breast Service Department of Medicine Memorial Sloan Kettering Cancer Center New York NY

Prospective Registry of Multiplex Testing United States and Europe Clinical Genetics Service Department of Medicine Memorial Sloan Kettering Cancer Center New York NY

Prospective Registry of Multiplex Testing United States and Europe Dana Farber Cancer Institute Boston MA

Prospective Registry of Multiplex Testing United States and Europe Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN

School of Women's and Children's Health Faculty of Medicine University of New South Wales Sydney Sydney New South Wales Australia The Kinghorn Cancer Centre Garvan Institute of Medical Research Sydney New South Wales Australia

Service de Génétique Institut Curie Paris France

Service de Génétique Institut Curie Paris France Genetics Department F76000 and Normandy University UNIROUEN INSERM U1245 Normandy Centre for Genomic and Personalized Medicine Rouen University Hospital Rouen France

Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Victoria Australia Parkville Familial Cancer Centre Peter MacCallum Cancer Center Melbourne Victoria Australia

The Research Institute of the McGill University Health Centre McGill University Montreal Quebec Canada Departments of Human Genetics Oncology and Medicine McGill University Montreal Quebec Canada

The Research Institute of the McGill University Health Centre McGill University Montreal Quebec Canada The Goodman Cancer Research Centre McGill University Montreal Quebec Canada

Unit of Medical Genetics Department of Medical Oncology and Hematology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy

Unit of Medical Oncology Department of Oncology and Hematology Papa Giovanni XXIII Hospital Bergamo Italy

Unit of Molecular Basis of Genetic Risk and Genetic Testing Department of Research Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy

University Malaya Cancer Research Institute Faculty of Medicine University Malaya Kuala Lumpur Malaysia

University Malaya Cancer Research Institute Faculty of Medicine University Malaya Kuala Lumpur Malaysia Cancer Research Malaysia Subang Jaya Selangor Malaysia

University of Florida Genetics Institute University of Florida Gainesville FL

Vanderbilt Ingram Cancer Center Division of Genetic Medicine Department of Medicine Vanderbilt University Medical Center Nashville TN

Wessex Clinical Genetics Service Princess Anne Hospital Southampton United Kingdom

Yorkshire Regional Genetics Service Chapel Allerton Hospital Leeds United Kingdom

References provided by Crossref.org

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$a Cancer Risks Associated With Germline PALB2 Pathogenic Variants: An International Study of 524 Families / $c X. Yang, G. Leslie, A. Doroszuk, S. Schneider, J. Allen, B. Decker, AM. Dunning, J. Redman, J. Scarth, I. Plaskocinska, C. Luccarini, M. Shah, K. Pooley, L. Dorling, A. Lee, MA. Adank, J. Adlard, K. Aittomäki, IL. Andrulis, P. Ang, J. Barwell, JL. Bernstein, K. Bobolis, Å. Borg, C. Blomqvist, KBM. Claes, P. Concannon, A. Cuggia, JO. Culver, F. Damiola, A. de Pauw, O. Diez, JS. Dolinsky, SM. Domchek, C. Engel, DG. Evans, F. Fostira, J. Garber, L. Golmard, EL. Goode, SB. Gruber, E. Hahnen, C. Hake, T. Heikkinen, JE. Hurley, R. Janavicius, Z. Kleibl, P. Kleiblova, I. Konstantopoulou, A. Kvist, H. Laduca, ASG. Lee, F. Lesueur, ER. Maher, A. Mannermaa, S. Manoukian, R. McFarland, W. McKinnon, A. Meindl, K. Metcalfe, NA. Mohd Taib, J. Moilanen, KL. Nathanson, S. Neuhausen, PS. Ng, T. Nguyen-Dumont, SM. Nielsen, F. Obermair, K. Offit, OI. Olopade, L. Ottini, J. Penkert, K. Pylkäs, P. Radice, SJ. Ramus, V. Rudaitis, L. Side, R. Silva-Smith, V. Silvestri, AB. Skytte, T. Slavin, J. Soukupova, C. Tondini, AH. Trainer, G. Unzeitig, L. Usha, T. van Overeem Hansen, J. Whitworth, M. Wood, CH. Yip, SY. Yoon, A. Yussuf, G. Zogopoulos, D. Goldgar, JL. Hopper, G. Chenevix-Trench, P. Pharoah, SHL. George, J. Balmaña, C. Houdayer, P. James, Z. El-Haffaf, H. Ehrencrona, M. Janatova, P. Peterlongo, H. Nevanlinna, R. Schmutzler, SH. Teo, M. Robson, T. Pal, F. Couch, JN. Weitzel, A. Elliott, M. Southey, R. Winqvist, DF. Easton, WD. Foulkes, AC. Antoniou, M. Tischkowitz,
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$a PURPOSE: To estimate age-specific relative and absolute cancer risks of breast cancer and to estimate risks of ovarian, pancreatic, male breast, prostate, and colorectal cancers associated with germline PALB2 pathogenic variants (PVs) because these risks have not been extensively characterized. METHODS: We analyzed data from 524 families with PALB2 PVs from 21 countries. Complex segregation analysis was used to estimate relative risks (RRs; relative to country-specific population incidences) and absolute risks of cancers. The models allowed for residual familial aggregation of breast and ovarian cancer and were adjusted for the family-specific ascertainment schemes. RESULTS: We found associations between PALB2 PVs and risk of female breast cancer (RR, 7.18; 95% CI, 5.82 to 8.85; P = 6.5 × 10-76), ovarian cancer (RR, 2.91; 95% CI, 1.40 to 6.04; P = 4.1 × 10-3), pancreatic cancer (RR, 2.37; 95% CI, 1.24 to 4.50; P = 8.7 × 10-3), and male breast cancer (RR, 7.34; 95% CI, 1.28 to 42.18; P = 2.6 × 10-2). There was no evidence for increased risks of prostate or colorectal cancer. The breast cancer RRs declined with age (P for trend = 2.0 × 10-3). After adjusting for family ascertainment, breast cancer risk estimates on the basis of multiple case families were similar to the estimates from families ascertained through population-based studies (P for difference = .41). On the basis of the combined data, the estimated risks to age 80 years were 53% (95% CI, 44% to 63%) for female breast cancer, 5% (95% CI, 2% to 10%) for ovarian cancer, 2%-3% (95% CI females, 1% to 4%; 95% CI males, 2% to 5%) for pancreatic cancer, and 1% (95% CI, 0.2% to 5%) for male breast cancer. CONCLUSION: These results confirm PALB2 as a major breast cancer susceptibility gene and establish substantial associations between germline PALB2 PVs and ovarian, pancreatic, and male breast cancers. These findings will facilitate incorporation of PALB2 into risk prediction models and optimize the clinical cancer risk management of PALB2 PV carriers.
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$a Leslie, Goska $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
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$a Doroszuk, Alicja $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
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$a Schneider, Sandra $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
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$a Decker, Brennan $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD. Department of Pathology, Brigham and Women's Hospital, Boston, MA.
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$a Dunning, Alison M $u Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom.
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$a Redman, James $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
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$a Scarth, James $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
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$a Plaskocinska, Inga $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
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$a Luccarini, Craig $u Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom.
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$a Shah, Mitul $u Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom.
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$a Pooley, Karen $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
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$a Adank, Muriel A $u Family Cancer Clinic, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
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$a Adlard, Julian $u Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, United Kingdom.
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$a Aittomäki, Kristiina $u Department of Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
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$a Andrulis, Irene L $u Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada.
700    1_
$a Ang, Peter $u Laboratory of Molecular Oncology, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore.
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$a Barwell, Julian $u Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
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$a Bernstein, Jonine L $u Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
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$a Bobolis, Kristie $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA.
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$a Borg, Åke $u Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
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$a Blomqvist, Carl $u Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
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$a Claes, Kathleen B M $u Centre for Medical Genetics, Ghent University, Ghent, Belgium.
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$a Concannon, Patrick $u University of Florida Genetics Institute, University of Florida, Gainesville, FL.
700    1_
$a Cuggia, Adeline $u The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada. The Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.
700    1_
$a Culver, Julie O $u Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA.
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$a Damiola, Francesca $u Biopathologie, Centre Léon Bérard, Lyon, France.
700    1_
$a de Pauw, Antoine $u Service de Génétique, Institut Curie, Paris, France.
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$a Diez, Orland $u Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d'Hebron Institute of Oncology (VHIO), University Hospital, Vall d'Hebron, Barcelona, Spain.
700    1_
$a Dolinsky, Jill S $u Ambry Genetics, Aliso Viejo, CA.
700    1_
$a Domchek, Susan M $u Department ofMedicine, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Prospective Registry of Multiplex Testing (PROMPT), United States and Europe.
700    1_
$a Engel, Christoph $u Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.
700    1_
$a Evans, D Gareth $u Division of Evolution and Genomic Sciences, University of Manchester; Manchester Centre for Genomic Medicine, St Mary's Hospital-Manchester University Hospitals NHS Foundation Trust; and Manchester Academic Health Science Centre, Manchester, United Kingdom.
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$a Fostira, Florentia $u Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos," Athens, Greece.
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$a Garber, Judy $u Prospective Registry of Multiplex Testing (PROMPT), United States and Europe. Dana-Farber Cancer Institute, Boston, MA.
700    1_
$a Golmard, Lisa $u Service de Génétique, Institut Curie, Paris, France.
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$a Goode, Ellen L $u Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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$a Gruber, Stephen B $u City of Hope National Medical Center, Duarte, CA.
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$a Hahnen, Eric $u Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany. Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany.
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$a Hake, Christopher $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA.
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$a Heikkinen, Tuomas $u Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
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$a Hurley, Judith E $u Division of Medical Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
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$a Janavicius, Ramunas $u Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania. State Research Institute Innovative Medicine Center, Vilnius, Lithuania.
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$a Kleibl, Zdenek $u Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
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$a Kleiblova, Petra $u Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic. Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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$a Konstantopoulou, Irene $u Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos," Athens, Greece.
700    1_
$a Kvist, Anders $u Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
700    1_
$a Laduca, Holly $u Ambry Genetics, Aliso Viejo, CA.
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$a Lee, Ann S G $u Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. SingHealth Duke-NUS Oncology Academic Clinical Programme (ONCO ACP), Duke-NUS Medical School, Singapore.
700    1_
$a Lesueur, Fabienne $u INSERM U900, Institut Curie, PSL University, Mines ParisTech, Paris, France.
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$a Maher, Eamonn R $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
700    1_
$a Mannermaa, Arto $u Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
700    1_
$a Manoukian, Siranoush $u Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
700    1_
$a McFarland, Rachel $u Ambry Genetics, Aliso Viejo, CA. Department of Epidemiology, University of California, Irvine, Irvine, CA.
700    1_
$a McKinnon, Wendy $u Familial Cancer Program, The University of Vermont Cancer Center, Burlington, VT.
700    1_
$a Meindl, Alfons $u Department of Gynecology and Obstetrics, Ludwig-Maximilians University of Munich, Munich, Germany.
700    1_
$a Metcalfe, Kelly $u Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
700    1_
$a Mohd Taib, Nur Aishah $u University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
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$a Moilanen, Jukka $u Department of Clinical Genetics, Oulu University Hospital, Medical Research Center Oulu and PEDEGO Research Unit, University of Oulu, Oulu, Finland.
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$a Nathanson, Katherine L $u Department ofMedicine, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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$a Neuhausen, Susan $u Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA.
700    1_
$a Ng, Pei Sze $u University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. Cancer Research Malaysia, Subang Jaya Selangor, Malaysia.
700    1_
$a Nguyen-Dumont, Tu $u Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
700    1_
$a Nielsen, Sarah M $u Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL.
700    1_
$a Obermair, Florian $u Institute of Medical Genetics, Kepler University Hospital Linz and Laboratory for Molecular Biology and Tumor Cytogenetics, Ordensklinikum Linz, Linz, Austria.
700    1_
$a Offit, Kenneth $u Prospective Registry of Multiplex Testing (PROMPT), United States and Europe. Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
700    1_
$a Olopade, Olufunmilayo I $u Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL.
700    1_
$a Ottini, Laura $u Department of Molecular Medicine, University La Sapienza, Rome, Italy.
700    1_
$a Penkert, Judith $u Department of Human Genetics, Hannover Medical School, Hannover, Germany.
700    1_
$a Pylkäs, Katri $u Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, and Northern Finland Laboratory Centre, Oulu, Finland.
700    1_
$a Radice, Paolo $u Unit of Molecular Basis of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
700    1_
$a Ramus, Susan J $u School of Women's and Children's Health, Faculty of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia. The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia.
700    1_
$a Rudaitis, Vilius $u Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania.
700    1_
$a Side, Lucy $u Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom.
700    1_
$a Silva-Smith, Rachel $u Department of Genetics, University of MiamiMiller School of Medicine, Miami, FL.
700    1_
$a Silvestri, Valentina $u Department of Molecular Medicine, University La Sapienza, Rome, Italy.
700    1_
$a Skytte, Anne-Bine $u Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.
700    1_
$a Slavin, Thomas $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA. Department of Medical Oncology, Division of Clinical Cancer Genomics, City of Hope, Duarte, CA.
700    1_
$a Soukupova, Jana $u Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
700    1_
$a Tondini, Carlo $u Unit of Medical Oncology, Department of Oncology and Hematology,Papa Giovanni XXIII Hospital, Bergamo, Italy.
700    1_
$a Trainer, Alison H $u Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia. Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.
700    1_
$a Unzeitig, Gary $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA.
700    1_
$a Usha, Lydia $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA.
700    1_
$a van Overeem Hansen, Thomas $u Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
700    1_
$a Whitworth, James $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
700    1_
$a Wood, Marie $u Familial Cancer Program, The University of Vermont Cancer Center, Burlington, VT.
700    1_
$a Yip, Cheng Har $u Cancer Research Malaysia, Subang Jaya Selangor, Malaysia.
700    1_
$a Yoon, Sook-Yee $u Cancer Research Malaysia, Subang Jaya Selangor, Malaysia.
700    1_
$a Yussuf, Amal $u Ambry Genetics, Aliso Viejo, CA.
700    1_
$a Zogopoulos, George $u The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada. The Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.
700    1_
$a Goldgar, David $u Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT.
700    1_
$a Hopper, John L $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
700    1_
$a Chenevix-Trench, Georgia $u Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
700    1_
$a Pharoah, Paul $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
700    1_
$a George, Sophia H L $u Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
700    1_
$a Balmaña, Judith $u Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d'Hebron Institute of Oncology (VHIO), University Hospital, Vall d'Hebron, Barcelona, Spain. Prospective Registry of Multiplex Testing (PROMPT), United States and Europe.
700    1_
$a Houdayer, Claude $u Service de Génétique, Institut Curie, Paris, France. Genetics Department, F76000 and Normandy University, UNIROUEN, INSERM U1245, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, Rouen, France.
700    1_
$a James, Paul $u Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia. Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.
700    1_
$a El-Haffaf, Zaki $u Department of Genetics, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
700    1_
$a Ehrencrona, Hans $u Department of Clinical Genetics and Pathology, Department of Laboratory Medicine, Office for Medical Services, Lund, Sweden. Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden.
700    1_
$a Janatova, Marketa $u Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
700    1_
$a Peterlongo, Paolo $u Genome Diagnostics Program, IFOM-The FIRC Institute for Molecular Oncology, Milan, Italy.
700    1_
$a Nevanlinna, Heli $u Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
700    1_
$a Schmutzler, Rita $u Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany. Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany.
700    1_
$a Teo, Soo-Hwang $u University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. Cancer Research Malaysia, Subang Jaya Selangor, Malaysia.
700    1_
$a Robson, Mark $u Prospective Registry of Multiplex Testing (PROMPT), United States and Europe. Breast Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
700    1_
$a Pal, Tuya $u Vanderbilt-Ingram Cancer Center, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
700    1_
$a Couch, Fergus $u Prospective Registry of Multiplex Testing (PROMPT), United States and Europe. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
700    1_
$a Weitzel, Jeffrey N $u Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA. Department of Medical Oncology, Division of Clinical Cancer Genomics, City of Hope, Duarte, CA.
700    1_
$a Elliott, Aaron $u Ambry Genetics, Aliso Viejo, CA.
700    1_
$a Southey, Melissa $u Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
700    1_
$a Winqvist, Robert $u Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, and Northern Finland Laboratory Centre, Oulu, Finland.
700    1_
$a Easton, Douglas F $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
700    1_
$a Foulkes, William D $u The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada. Departments of Human Genetics, Oncology, and Medicine, McGill University, Montreal, Quebec, Canada.
700    1_
$a Antoniou, Antonis C $u Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
700    1_
$a Tischkowitz, Marc $u Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom.
773    0_
$w MED00002596 $t Journal of clinical oncology : official journal of the American Society of Clinical Oncology $x 1527-7755 $g Roč. 38, č. 7 (2020), s. 674-685
856    41
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