Open access peer-reviewed chapter

Implications of BRCA1 and BRCA2 Mutations in Mexico

Written By

Carlos Arturo Gonzalez Nuñez, Paula Anel Cabrera Galeana, Sandy Ruiz Cruz and Alexandra Garcilazo Reyes

Submitted: 07 August 2022 Reviewed: 17 August 2022 Published: 17 January 2023

DOI: 10.5772/intechopen.107144

From the Edited Volume

BRCA1 and BRCA2 Mutations - Diagnostic and Therapeutic Implications

Edited by Mani T. Valarmathi

Chapter metrics overview

92 Chapter Downloads

View Full Metrics


BRCA 1 or BRCA 2 mutations have played a role in understanding its risk for several different cancer like breast, ovarian, prostate, and pancreatic cancer Knowing that biology is king, and its determination plays a role in prognosis for patients with cancer. Several recommendations have been made focusing on which population should have BRCA mutational status determined. This determination could help seek targeted therapy that could have a beneficial impact on cancer patients. Having this said, efforts have been made to determine if our Mexican population has the same prognosis when BRCA mutation is present when compared to global reports. As well as researching founder mutations that could help understand our Mexican population. This chapter seeks to describe and analysis this current scenario in Mexican population with BRCA mutation.


  • BRCA1
  • BRCA2
  • BRCA 1/2
  • breast cancer
  • ovarian cancer
  • prostate cancer
  • Latin cancer patients
  • Mexican cancer patients
  • Mexico
  • founder mutations

1. Introduction

BRCA 1 or BRCA 2 mutations, implicate a different prognosis depending on the type of neoplasm its associated with. Having this said, in ovarian cancer, those with BRCA mutational status have been associated with a better prognosis compared to those without BRCA mutational status [1]. This also seems to be the case in breast cancer, although different reports have concluded mixed results in the scene that BRCA mutational is not always associated with a better cancer prognosis [2, 3]. These mixed results could probably be explained by different factors, taking in account race, country of origin which could represent different founder BRCA mutations. We would like to describe the prevalence of BRCA 1/2 in Mexico, as well as founder mutations of BRCA in our population, and the impact it translates in our daily practice.


2. BRCA 1/2 mutations and breast cancer in Mexico

Breast cancer is the most common neoplasm worldwide, this also seems to be the case in Mexico; with 195,499 new cases of cancer reported in 2020 of which 15.3% (29,929) where associated with breast cancer [4]. Breast cancer has incremented in its incidence and mortality in Mexico during the last three decades, according to the last report made by the Epidemiology Department in the Secretary of Health, with an initial incidence of 10.76 cases per 100,000 habitants to 26.1 cases per 100,000 habitants in women of 25 years of age or older [5]. This clearly depicts how breast cancer is considered a public health problem that requires a focused diagnosis with an accurate treatment, considering the different epidemiology set in our country.

Although breast cancer is the most common cancer, as is mostly reported in the rest of the world there a few differences to consider. In Mexico, the mean age of diagnosis is 52.5 years, considered 10 years younger when compared to the rest of the world. Of these patients, approximately 13.3% are 40 years of age or younger at time of diagnosis [6, 7].

The associations between risk factors and breast cancer in the Latin American population have been considered complex due to the extensive diversity of cultures and ancestral origins that may be contributing for the risk of breast cancer [8].

Mexico has had a demographic, epidemiological and economic transition that has favored the increase of risk factors for breast cancer (increased age, obesity and diabetes) [9]. This younger population should be considered relevant since screening for BRCA 1 or BRCA 2 mutation is recommended for patients younger than 45 years of age with a family history of breast cancer [10].

Some international recommendations for searching for BRCA mutations vary according to associations and regions. For example The National Comprehesive Cancer Network (NCCN) recommends testing in: diagnosis of breast cancer in a patient under 45 years of age, patient between 45 and 50 years of age with synchronous or metachronous breast cancer or associated with a first-degree relative with ovarian, breast, prostate, pancreas, and breast cancer older than 51 years with ovarian cancer, pancreas and finally patient of any age with: triple negative breast cancer, male breast cancer and in which the result can define the use of a PARP inhibitor. The European Society for Medical Oncology (ESMO) recommends BRCA determination in patients with breast cancer if the age upon diagnosis is 40 years or less, as well as those with bilateral breast cancer at the age of 50 or less, and in those with triple negative breast cancer at the age of 60 or less. Two first degree relatives with breast cancer, ovarian cancer, prostate cancer, pancreatic cancer is also motive for BRCA mutational status determination [11].

These screening recommendations are also following in our clinical practice, because there aren’t current guidelines in Mexico for the determination of mutation in BRCA 1 and/or BRCA2 extrapolating international guideline recommendations in our daily practice.

Although much of our daily practice is extrapolated from international guidelines. BRCA 1/2 mutations have been a source of investigation for the past decade. In Mexico a prevalence of varying from 17.4 to 30% of BRCA 1 or 2 mutations has been described, [12, 13] which is higher than what has been reported in our countries with 3% in all patients diagnosed with breast cancer, and 20% in those with high-risk families [14]. We previously mentioned that breast cancer is diagnosed at a younger age in Mexico, this could partially explain why prevalence in BRCA mutations is different from what has been described in other countries. Not only is our prevalence different, but also the subtype of breast cancer associated with BRCA mutations. In general, Basal-like subtype breast cancer is associated with BRCA 1 mutation and BRCA 2 with Luminal B-like subtype [15]. In Latin America, 37.1% with BRCA mutations have positive Estrogen and Progesterone receptors, with only 17.8% considered Triple negative with BRCA mutation, although this was not analyzed according to the type of BRCA mutation [13]. This proves that breast cancer is an heterogenous disease that also differs between countries. This led to an effort in investigating the presence of founder BRCA mutations in Mexico. The Hispanic mutation panel (HISPANEL) was designed due to the need of an inexpensive accessible screening tool to properly diagnosis patients with high for BRCA mutations.

HISPANEL incorporates 115 BRCA mutations observed in Hispanic women. It is estimated that among Mexican women with breast or ovarian cancer it has a sensitivity of 68% [14]. This panel led to the discovery of the first Mexican BRCA founder mutation, BRCA1 ex9–12del large rearrangement, which is present in 12% of all BRCA1 mutations in patients with family history of breast cancer [16].

This was further studied in patients without family history of breast cancer, where 67% patients with locally advanced breast cancer and only 2% with metastatic disease were analyzed [17]. This should be considered an important subjective of discussion due to adjuvant treatment in locally advanced breast cancer as well as second line treatment for metastasis breast cancer with Olaparib [18]. This will further be described in the treatment section. Surprisingly, out of 96 patients with breast cancer analyzed, 29% patients had BRCA1 ex9–12del founder mutation [17].

Some recurrent mutations found in the Mexican population are shown in Table 1 [19].

BRCA1 VariantBRCA2

Table 1.

BRCA mutations found in Mexican patients.

This leads us to think that BRCA mutation should be determined in patients with 50 years of age or younger and breast cancer diagnosis, independent of family history for breast cancer. BRCA1 ex9–12del mutation is not routinely analyzed when searching for BRCA mutations in breast cancer patients. An important aspect to consider when determining BRCA mutations is the presence of copy-number variants (CNV), which are hypothesized to have a better prognosis since they are less susceptible to reversal mutations leading to less resistance to DNA-damaging therapies [20]. This was shown in a cohort study from the HISPANEL population, where those patients with BRCA CNV had better overall survival (OS) when compared to those with BRCA pathologic variants at 10 years; respectively 100% vs. 78.6% [13]. The growing access to diagnostic tests for BRCA mutational status could help analyze this information at a larger scale. What is true is due to recent approbation by the Federal Commission for the Protection Against Sanitary Risks (COFEPRIS) for the use of a PARP inhibitor name Olaparib, there has been collaborations with different laboratories in performing a BRCA mutational status test across the country. This has allowed to further indicate PARP inhibitors as a 2nd line treatment option in triple negative metastatic breast cancer, as well as an in hormonal receptor positive HER2 negative metastatic breast cancer, according to NCCN guidelines [18].

Olaparib, a PARP inhibitor, is also used for triple negative early disease breast cancer with residual disease after neoadjuvant chemotherapy, and those with tumor size of 2 cm or axillary node-positive disease who received standard adjuvant chemotherapy. In the case of hormone receptor positive HER2 negative early breast cancer, those who received standard adjuvant chemotherapy, who had 4 pathologically confirmed positive lymph nodes or those who received neoadjuvant chemotherapy with a CPS + EG score of 3 or more, should receive Olaparib; considering these scenarios only in those the germline BRCA mutations [21].

For patients with somatic BRCA mutations, there is only information in metastatic breast cancer, which was analyzed in a Phase II clinical trial, observing an objective response of 50%, for those with BRCA somatic mutations [22]. This is an important aspect to consider when determining BRCA mutational status in our patients, considering that most of the information, and approval for certain drugs are in BRCA germline mutations. The difference of at least objective response between germline mutations and somatic BRCA mutations when using PARP inhibitors, like Olaparib, has not been studied in Mexican population with breast cancer. This could be an area of clinical investigation in our field, considering higher access to BRCA mutational determination tests in certain parts of the country.

Another aspect to consider is the sequence of treatment in when to initiate PARP inhibitors in metastatic breast cancer. Most guidelines (ESMO, NCCN) recommend initiating after progressive disease to first line palliative therapy [18, 23]. This could seem straightforward, due to the fact the Olaparib and Talazoparib are not associated with overall survival benefit [24, 25] considering that other first line palliative options are associated with this oncologic outcome (overall survival). This should be considered with caution, considering BRCA germline patients have a different biologic behavior. To set an example, although there is no doubt the CDK4/6 inhibitors combined with hormonal therapy revolutionized different oncologic outcomes in hormone receptor positive HER2 negative metastatic breast cancer, this does not seem to be the case in patients with germline BRCA mutational status. Overall survival is lower in patients with gBRCA mutational status patients who were treated with CDK4/6 inhibitors when compared to those with wild type BRCA mutational status [26], considering this information. It could also be a field of opportunity in investigation frontline CDK 4/6 inhibitors with hormonal therapy versus PARP inhibitors, not only in our Mexican population, but also in other countries. The same question could be asked for HER2 positive patients, where PARP inhibition with antiHER2 therapy has been shown to enhance the effect of antiHER2 therapy like trastuzumab [27].


3. BRCA 1/2 mutations and ovarian cancer in Mexico

Ovarian cancer represents the 14th most common cancer in Mexico, according to GLOBOCAN 2020, ranking itself in 12th place for mortality [4]. This risk could be increased for those with BRCA mutations, from 1.2% to 39–44% in those with BRCA1 mutations and 11–17% in BRCA mutations [28, 29]. This also seems to persist in Mexican patients, with a risk of 40% for ovarian cancer in those BRCA mutations [30]. Not only BRCA mutational status is considered a risk for Ovarian cancer, but it also implicates a prognosis factor, as well as a therapeutic opportunity due to the use of poly (ADP-ribose) (PARP) inhibitors [31]. When analyzing it’s prognosis value, those with BRCA1 mutational status have a worse recurrence free survival when compared with those with BRCA2 in Mexican patients with ovarian cancer [30]. This is also true when analyzing the same founder mutation, previously mentioned in the breast cancer section. Those with BRCA1 ex9–12del, which was present in (28.2%) of 179 patients analyzed compared to other BRCA1 mutations had a better recurrence free survival [30]. Knowing that BRCA mutational status has a prognosis value, this clearly reflects the necessity to have more access to BRCA tests in our population. Not only, does mutational prognosis value, but also a therapeutic opportunity. PARP inhibitors, such as Olaparib have different clinical indications, such as maintenance therapy after 1st line therapy, as well after maintenance therapy after 2 or more lines of chemotherapy [32]. In Mexico, those patients treated with Olaparib had a median progression-free survival of 12 months after 2 lines or more of chemotherapy vs. 8.3 months after 4 or more lines of chemotherapy [33]. These results are similar to what was reported in the SOLO-2 trial reporting a median progression-free survival with olaparib (19·1 months [95% CI 16·3–25·7]) than with placebo (5·5 months [5·2–5·8]; hazard ratio [HR] 0·30 [95% CI 0·22–0·41], p < 0·0001); there was also benefit in in overall survival of 51·7 months (95% CI 41·5–59·1) with olaparib and 38·8 months (31·4–48·6) with placebo (hazard ratio 0·74 [95% CI 0·54–1·00]; p = 0·054, [34, 35]. Considering the previous outcomes, it’s clear why all patients which ovarian cancer, should be tested for BRCA mutational status. If a founder mutation determination is available, it should be performed. In an observational study 107 out of 377 patients were with BRCA mutation, of which 77 patients (72.9%) had BRCA1 mutation where 27.3%of these patients had the founder mutation BRCA1-Del ex9–12. When analyzing progression-free survival, patients treated with Olaparib with BRCA1-Del ex9–12 had a longer progressive free survival when compared to the rest of Mexican patients with BRCA 1 or BRCA 2 mutation treated with Olaparib [36].


4. BRCA 1/2 mutations and prostate cancer in Mexico

Although Prostate cancer is the most common cancer in Men in Mexico, [4], where those with BRCA mutational status have a higher risk of developing prostate cancer, only 1.2% to 3.2% are associated to BRCA2 mutations, even less cases to BRCA1 [37]. Although the prevalence of BRCA2 mutational status es low, it’s presence is considered of poor prognosis. When compared with the general population with prostate cancer, those with BRCA2 mutation had a 12-year cancer-specific survival of 61.8% compared to 94.3% to those without BRCA2 mutation [38]. Due to its low prevalence, as well as low access to BRCA diagnosis tests, information on its impact in Mexico is scarce. In an observational study performed in a tertiary hospital in Mexico City, out of 22 patients with Castration naïve and Castration resistant prostate cancer, only 3 patients had BRCA mutational status. Contrary to global incidence, in this study BRCA1 mutational status more common than BRCA2, where all 3 patients had castration resistant prostate cancer [38]. Due to the recent approval of Olaparib in the metastatic setting in Mexico, there is not any prospective data showing its use and impact in Mexico. Even though we lack information from our population, we believe that BRCA mutational status should be determined primarily based on family history of other BRCA-related cancers.


5. Concluding remarks

As it most Latin American countries, in Mexico access to diagnosis tests is primarily an obstacle that has been resolving in the last year having more access to BRCA determination with the help of distant programs sponsored by private companies which the intention to detect which patients could benefit from PARP inhibitors. This access could help us determinate the prognosis in our population to those with BRCA mutations, as well as its impact when treated with PARP inhibitors, most of them are approved in our country. This specific population requires a directed investigation as was the case with breast and ovarian cancer where those with founder mutations had a different prognosis and response to treatment. Access not only to BRCA mutation diagnosis test, but also to founder mutations determinations is an objective that should be available in the next years to come.


Conflict of interest

The authors declare no conflict of interest.


  1. 1. Kim SI, Lee M, Kim HS, Chung HH, Kim JW, Park NH, et al. Effect of BRCA mutational status on survival outcome in advanced-stage high-grade serous ovarian cancer. Journal of Ovarian Research. 2019;12(1)
  2. 2. Maksimenko J, Irmejs A, Nakazawa-Miklasevica M, Melbarde-Gorkusa I, Trofimovics G, Gardovskis J, et al. Prognostic role of BRCA1 mutation in patients with triple-negative breast cancer. Oncology Letters. 2014;7(1):278-284
  3. 3. Huszno J, Kołosza Z, Grzybowska EWA. BRCA1 mutation in breast cancer patients: Analysis of prognostic factors and survival. Oncology Letters. 2019;17(2):1986-1995
  4. 4. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a Cancer Journal for Clinicians. 2021;71(3):209-249
  5. 5. Mexicana G de. Tercera revisión del Consenso Nacional sobre Diagnóstico y Tratamiento del Cáncer Mamario. Available from:
  6. 6. Aura D, Erazo A, Solís V. Publicación Oficial de la Sociedad Mexicana de Oncología [Internet]. Available from:
  7. 7. Cárdenas-Sánchez J, Bargalló-Rocha E, Valle AE, Maafs-Molina E, Chacón AP, Clave P. Consenso Mexicano sobre Diagnóstico y Tratamiento del Cáncer Mamario [Internet]. Vol. 12. 2013. Available from:*Autorparacorrespondencia:Correoelectróáginadelconsenso:
  8. 8. Cáncer de mama en mujeres jóvenes en México- necesidades y retos clínicos
  9. 9. Romero-Cordoba SL, Salido-Guadarrama I, Rebollar-Vega R, Bautista-Piña V, Dominguez-Reyes C, Tenorio-Torres A, et al. Comprehensive omic characterization of breast cancer in Mexican-Hispanic women. Nature Communications. 2021;12(1)
  10. 10. Buys SS, Dickson P, Domchek SM, Elkhanany A, Friedman S, Goggins M, et al. NCCN Guidelines Version 2.2022 Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic Vanderbilt-Ingram Cancer Center [Internet]. 2022. Available from:
  11. 11. Paluch-Shimon S, Cardoso F, Sessa C, Balmana J, Cardoso MJ, Gilbert F, et al. Prevention and screening in BRCA mutation carriers and other breast/ovarian hereditary cancer syndromes: ESMO clinical practice guidelines for cancer prevention and screening. Annals of Oncology. 2016;27:v103-v110
  12. 12. Med A, Vázquez JD, et al. Prevalencia de mutación germinal en CM INTRODUCCIÓN [Internet]. Vol. 66. 2021. Available from:
  13. 13. Herzog JS, Chavarri-Guerra Y, Castillo D, Abugattas J, Villarreal-Garza C, Sand S, et al. Genetic epidemiology of BRCA1- and BRCA2-associated cancer across Latin America. NPJ Breast Cancer. 2021;7(1)
  14. 14. Armstrong N, Ryder S, Forbes C, Ross J, Quek RGW. A systematic review of the international prevalence of BRCA mutation in breast cancer. In: Clinical Epidemiology. Vol. 11. Dove Medical Press Ltd; 2019. pp. 543-561
  15. 15. Larsen MJ, Kruse TA, Tan Q , Lænkholm AV, Bak M, Lykkesfeldt AE, et al. Classifications within molecular subtypes enables identification of BRCA1/BRCA2 mutation carriers by RNA tumor profiling. PLoS One. 2013;8(5)
  16. 16. Weitzel JN, Clague J, Martir-Negron A, Ogaz R, Herzog J, Ricker C, et al. Prevalence and type of BRCA mutations in Hispanics undergoing genetic cancer risk assessment in the southwestern United States: A report from the clinical cancer genetics community research network. Journal of Clinical Oncology. 2013;31(2):210-216
  17. 17. Villarreal-Garza C, Alvarez-Gómez RM, Pérez-Plasencia C, Herrera LA, Herzog J, Castillo D, et al. Significant clinical impact of recurrent BRCA1 and BRCA2 mutations in Mexico. Cancer. 2015;121(3):372-378
  18. 18. Rashmi Kumar N, Berardi R, Abraham J, Aft R, Agnese D, Allison KH, et al. NCCN Guidelines Version 4.2022 Breast Cancer [Internet]. 2022. Available from: https://www.nccn
  19. 19. Villarreal-Garza C, Weitzel JN, Llacuachaqui M, Sifuentes E, Magallanes-Hoyos MC, Gallardo L, et al. The prevalence of BRCA1 and BRCA2 mutations among young Mexican women with triple-negative breast cancer. Breast Cancer Research and Treatment. 2015;150(2):389-394
  20. 20. Gogola E, Rottenberg S, Jonkers J. Resistance to PARP inhibitors: Lessons from preclinical models of BRCA-associated cancer. Annual Review of Cancer Biology. 2019;3:235-254. [Internet]. DOI: 10.1146/annurev-cancerbio-030617
  21. 21. Tutt ANJ, Garber JE, Kaufman B, Viale G, Fumagalli D, Rastogi P, et al. Adjuvant Olaparib for patients with BRCA1- or BRCA2-mutated breast cancer. New England Journal of Medicine. 2021;384(25):2394-2405
  22. 22. Tung NM, Robson ME, Ventz S, Santa-Maria CA, Nanda R, Marcom PK, et al. TBCRC 048: Phase II study of Olaparib for metastatic breast cancer and mutations in homologous recombination-related genes. Journal of Clinical Oncology. 2020;38:4274-4282 [Internet]
  23. 23. Gennari A, André F, Barrios CH, Cortés J, de Azambuja E, DeMichele A, et al. ESMO clinical practice guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer ☆. Annals of Oncology. 2021;32(12):1475-1495
  24. 24. Litton JK, Hurvitz SA, Mina LA, Rugo HS, Lee KH, Gonçalves A, et al. Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: Final overall survival results from the EMBRACA trial. Annals of Oncology. 2020;31(11):1526-1535
  25. 25. Robson ME, Tung N, Conte P, Im SA, Senkus E, Xu B, et al. OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician’s choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer. Annals of Oncology. 2019;30(4):558-566
  26. 26. Collins JM, Nordstrom BL, McLaurin KK, Dalvi TB, McCutcheon SC, Bennett JC, et al. A real-world evidence study of CDK4/6 inhibitor treatment patterns and outcomes in metastatic breast cancer by germline BRCA mutation status. Oncology and Therapy. 2021;9(2):575-589
  27. 27. García-Parra J, Dalmases A, Morancho B, Arpí O, Menendez S, Sabbaghi M, et al. Poly (ADP-ribose) polymerase inhibition enhances trastuzumab antitumour activity in HER2 overexpressing breast cancer. European Journal of Cancer. 2014;50(15):2725-2734
  28. 28. Antoniou A, Pharoah PDP, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: A combined analysis of 22 studies. American Journal of Human Genetics. 2003;72:1117-1130
  29. 29. Kuchenbaecker KB, Hopper JL, Barnes DR, Phillips KA, Mooij TM, Roos-Blom MJ, et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA - Journal of the American Medical Association. 2017;317(23):2402-2416
  30. 30. Gallardo-Rincón D, Álvarez-Gómez RM, Montes-Servín E, Toledo-Leyva A, Montes-Servín E, Michel-Tello D, et al. Clinical evaluation of BRCA1/2 mutation in Mexican ovarian cancer patients. Translational Oncology. 2020;13(2):212-220
  31. 31. Grafodatskaya D, O’Rielly DD, Bedard K, Butcher DT, Howlett CJ, Lytwyn A, et al. Practice guidelines for BRCA1/2 tumour testing in ovarian cancer. Journal of Medical Genetics. BMJ Publishing Group. 2022
  32. 32. Armstrong D, Alvarez R, Floor J, et al. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ®) NCCN Guidelines for Patients ® available at [Internet]. 2022. Available from:
  33. 33. Gallardo-Rincón D, Alamilla-García G, Montes-Servín E, Morales-Vázquez F, Cano-Blanco C, Coronel-Martínez J, et al. Experiencia con el uso de olaparib en pacientes con cáncer de ovario. Gaceta Médica de México. 2019;155(6):585-589
  34. 34. Pujade-Lauraine E, Ledermann JA, Selle F, Gebski V, Penson RT, Oza AM, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): A double-blind, randomised, placebo-controlled, phase 3 trial. The Lancet Oncology. 2017;18(9):1274-1284
  35. 35. Poveda A, Floquet A, Ledermann JA, Asher R, Penson RT, Oza AM, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): A final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial. The Lancet Oncology. 2021;22(5):620-631
  36. 36. Gallardo-Rincón D, Montes-Servín E, Alamilla-García G, Montes-Servín E, Bahena-González A, Cetina-Pérez L, et al. Clinical benefits of Olaparib in Mexican ovarian cancer patients with founder mutation BRCA1-Del ex9-12. Frontiers in Genetics. 2022;13
  37. 37. Prevention C, Hereditary G. Epidemiology accepted on a. The Role of BRCA Testing in Hereditary Pancreatic and Prostate Cancer Families 2019. Available from:
  38. 38. Akbari MR, Wallis CJ, Toi A, Trachtenberg J, Sun P, Narod SA, et al. The impact of a BRCA2 mutation on mortality from screen-detected prostate cancer. British Journal of Cancer. 2014;111(6):1238-1240

Written By

Carlos Arturo Gonzalez Nuñez, Paula Anel Cabrera Galeana, Sandy Ruiz Cruz and Alexandra Garcilazo Reyes

Submitted: 07 August 2022 Reviewed: 17 August 2022 Published: 17 January 2023