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High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome.
[cowden syndrome]
PTEN
hamartoma
tumour
syndrome
(
PHTS
)
encompasses
several
clinical
syndromes
with
germline
mutations
in
the
PTEN
tumour
suppressor
gene
,
including
Cowden
syndrome
which
is
characterised
by
an
increased
risk
of
breast
and
thyroid
cancers
.
Because
PHTS
is
rare
,
data
regarding
cancer
risks
and
genotype-phenotype
correlations
are
limited
.
The
objective
of
this
study
was
to
better
define
cancer
risks
in
this
syndrome
with
respect
to
the
type
and
location
of
PTEN
mutations
.
154
PHTS
individuals
with
a
deleterious
germline
PTEN
mutation
were
recruited
from
the
activity
of
the
Institut
Bergonié
genetic
laboratory
.
Detailed
phenotypic
information
was
obtained
for
146
of
them
.
Age
and
sex
adjusted
standardised
incidence
ratio
(
SIR
)
calculations
,
cumulative
cancer
risk
estimations
,
and
genotype-phenotype
analyses
were
performed
.
Elevated
SIRs
were
found
mainly
for
female
breast
cancer
(
39
.
1
,
95
%
CI
24
.
8
to
58
.
6
)
,
thyroid
cancer
in
women
(
43
.
2
,
95
%
CI
19
.
7
to
82
.
1
)
and
in
men
(
199
.
5
,
95
%
CI
106
.
39
to
342
.
03
)
,
melanoma
in
women
(
28
.
3
,
95
%
CI
7
.
6
to
35
.
4
)
and
in
men
(
39
.
4
,
95
%
CI
10
.
6
to
100
.
9
)
,
and
endometrial
cancer
(
48
.
7
,
95
%
CI
9
.
8
to
142
.
3
)
.
Cumulative
cancer
risks
at
age
70
were
85
%
(
95
%
CI
70
%
to
95
%
)
for
any
cancer
,
77
%
(
95
%
CI
59
%
to
91
%
)
for
female
breast
cancer
,
and
38
%
(
95
%
CI
25
%
to
56
%
)
for
thyroid
cancer
.
The
risk
of
cancer
was
two
times
greater
in
women
with
PHTS
than
in
men
with
PHTS
(
p
<
0
.
05
)
.
This
study
shows
a
considerably
high
cumulative
risk
of
cancer
for
patients
with
PHTS
,
mainly
in
women
without
clear
genotype-phenotype
correlation
for
this
cancer
risk
.
New
recommendations
for
the
management
of
PHTS
patients
are
proposed
.
Diseases
Validation
Diseases presenting
"including cowden syndrome which is characterised by an increased risk of breast and thyroid cancers"
symptom
cowden syndrome
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