What you should know
Heredity is belived to play a role in about 10 percent of all breast and ovarian cancers. In the last 15 years, researchers and scientists have made great advances in this area of medicine ? discovering the genes primarily responsible for these cancers and developing genetic tests to identify those at risk.
Who should get tested? According to Andrew Menzin, M.D., the associate chief of gynecologic oncology and the ob/gyn residency program director at North Shore Unviersity Hospital, a woman may consider genetic counseling and testing if she
- Has multiple family members with cancer
- Has herself had multiple cancers
- Has developed breast or ovarian cancer at an early age (i.e., premenopausal)
In certain instances, a patient?s background affects her chance of having a mutation, or genetic change, that may predispose to developing cancer. Individuals of Ashkenazi descent, for example, have a rate of BRCA mutations ? those that cause most hereditary breast and ovarian cancers ? much higher than that of the general population.
A genetic counselor will take the patient through the process, with counseling sessions both before and after the testing. The testing itself for the patient is often no more complicated than a blood test, but the counseling process is vital to a proper genetics evaluation.
If the patient is found to have a mutation, there are options she and her team of caregivers may decide to pursue. These include:
Surveillance ? This involves watching the patient more intensively with pelvic exams, ultrasound and the CA-125 ovarian cancer blood test, so that any cancers that do occur can be treated at the earliest possible time.
Chemoprevention ? This may involve prescribing a medication that can reduce the chances of developing cancer. For instance, tamoxifen can potentially decrease the risk of breast cancer, and oral contraceptives may reduce the likelihood of ovarian cancer.
Risk-reducing surgery ? These procedures remove the organs at risk in an attempt to preempt the development of cancer. Mastectomy and gynecologic surgery to remove the fallopian tubes and ovaries are examples of effective risk-reducing operations.
?If those with the risk factors do not get genetic testing, an opportunity for prevention and early diagnosis may be missed,? said Dr. Menzin.
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