PARP 抑制剂的推出彻底改变了患有 BRCA1/2 致病性种系变异的乳腺癌患者的管理和治疗。 PARP 抑制剂在临床环境中的实施可能具有挑战性，因为它们与其他药物（包括最近批准的药物和已证明有效的药物）的适应症重叠。这项研究利用德尔菲法提出了关于基因检测、PARP 抑制剂在早期和转移性环境中的使用以及管理这些新药潜在毒性的策略的第一个意大利共识。专家组一致同意各种问题，包括 BRCA1/2 基因检测的时机、技术和患者特征，以及 PARP 抑制剂在早期和晚期乳腺癌治疗方案中的适当位置。然而，一些领域的分歧变得明显，特别是在出于治疗目的使用腋窝手术以及在双侧乳房切除术和三阴性乳腺癌患者的降低风险的输卵管卵巢切除术中应用激素替代疗法方面。在这些特定领域需要进行更多研究，以改善对遗传风险增加的乳腺癌患者的护理。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

The introduction of PARP inhibitors has revolutionized the management and treatment of patients with pathogenic germline variants of BRCA1/2 who have developed breast cancer. The implementation of PARP inhibitors in clinical settings can be challenging due to their overlapping indications with other drugs, including both recently approved medications and those with proven efficacy. This study utilized the Delphi method to present the first Italian consensus regarding genetic testing, the use of PARP inhibitors in both early and metastatic settings, and strategies for managing the potential toxicity of these novel drugs. The Panel unanimously agreed on various issues, including the timing, techniques, and patient characteristics for BRCA1/2 genetic testing, andthe appropriate placement of PARP inhibitors in the treatment algorithm for both early and advanced breast cancer. Nevertheless, some areas of divergence became evident, particularly regarding the use of axillary surgery for therapeutic purposes and the application of hormone replacement therapy in cases of bilateral mastectomy and risk-reducing salpingo-oophorectomy for patients treated for triple negative breast cancer. Additional research is needed in these particular domains to improve the care of patients with breast cancer who bear an increased genetic risk.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.