MRI appearance of BRCA-associated prostate cancer

Published:February 18, 2022DOI:


      • BRCA-associated prostate cancers are more likely to have a high histological grade and a more aggressive clinical course.
      • BRCA gene mutation testing in selected prostate cancer patients may guide therapy and further genetic testing and counseling.
      • BRCA testing may be appropriate in patients with a concerning family history and large or advanced prostate cancer at MRI.


      Despite advances in diagnosis and treatment, prostate cancer remains the second leading cause of cancer related mortality in men. Prognosis is variable and dependent on several clinical and genetic factors, including BRCA gene mutations. Recent clinical studies have reported that BRCA-associated prostate cancer is a more aggressive subtype with a higher probability of nodal involvement and distant metastases at the time of diagnosis, but radiological findings have not been described. Accurate recognition of those tumors could help guide clinical management and prompt testing and counseling for BRCA mutations. We have recently encountered four patients with BRCA-associated prostate cancer who underwent multiparametric MRI. The MRI appearances of these tumors, which were generally locally advanced and aggressive in appearance, are presented to facilitate recognition of BRCA-associated prostate cancer and guide potential genetic testing and counseling.


      BRCA (breast cancer gene), DNA (deoxyribonucleic acid), PI-RADS (Prostate Imaging Reporting and Data System), MRI (magnetic resonance imaging), PSA (prostate specific antigen), ISUP (International Society of Urological Pathology)


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