Some kinds of cancers run in families. Our licensed genetic counselor, Melissa Hall, M.S., L.G.C., can evaluate your family history, discuss your risk, and screening and management options. If genetic testing is available, Melissa will talk to you about the test and help you decide if testing is right for you.
If you have had cancer at a young age, have had two or more separate cancers, or have several family members that have had cancer, you may want to think about genetic testing. For more information on genetic counseling and how to prepare for a genetic counseling appointment please download “A Guide to Genetic Counseling”.
Not all predispositions for cancer can be identified by a genetic test and testing is not helpful for everyone. Only about 5-10 percent of cancers occur because of an inherited risk. About 20 percent of cancers appear to “run in families” but there is no identifiable genetic change. Familial cancer is probably caused by several minor genetic changes in combination with a shared environment, or caused by genes that have not yet been identified. In other words, most cancers occur sporadically because of aging, exposures, and random mistakes that occur during normal cell division.
For individuals who have an inherited risk for breast cancer their risk can go up from a standard risk of breast cancer of about 12% by age 85 to as high as an 80% risk of breast cancer by age 85.
Two genes cause hereditary breast and ovarian cancer syndrome (HBOC) – BRCA1 and BRCA2. BRCA1 and BRCA2 also predispose to other cancers besides breast and ovarian cancer. There are other genes besides BRCA1 and BRCA2 that can predispose a person to develop breast cancer.
Knowing your family history can help a genetic counselor identify the most likely suspect for the cause of the cancer in your family and help you decide if testing is appropriate for you and your family. If you test positive for a predisposition for cancer, a genetic counselor can help you make decisions about prevention, screening, and management. Many people choose to have genetic testing, not only to help them make informed decisions about their own medical management, but to also provide information for other family members and for generations to come.
In the past people have had concerns about genetic testing because of a fear of discrimination, mainly by health insurance companies. On May 21 2008 — President Bush signed into law the Genetic Information Nondiscrimination Act (GINA) that protects Americans against discrimination based on their genetic information when it comes to health insurance and employment. The long-awaited measure will pave the way for people to take full advantage of the promise of personalized medicine without fear of discrimination. http://www.genome.gov/24519851
Other uses of genetic testing in breast cancer include determining one’s response to medications such as Tamoxifen (CYP 2D6) and targeted therapies such as PARP inhibitors in women who are known to have a mutation in BRCA1 or BRCA2. Breast Imaging of Oklahoma is a leader in offering all of these types of genetic assessment to provide women with complete information in order to make decisions regarding their care.
Melissa Hall MS, CGC, LGC is a certified licensed genetic counselor with Breast Imaging of Oklahoma in Edmond, Oklahoma. In this role, Melissa works in our high risk clinic, counsels and tests high risk women for hereditary cancer syndromes, and assists with research projects related to high risk and genetic issues. Melissa received her Bachelor of Science degree from the University of Central Oklahoma, and her Master of Science in Genetic Counseling from the University of Oklahoma Graduate College of Medicine.
Melissa has been with Breast Imaging of Oklahoma since 2006, first as a graduate student, and currently as the only licensed genetic counselor in Oklahoma specializing in breast cancer risk assessment and genetic testing for inherited breast cancer. Melissa’s graduate research focused on the ethical and legal obligation of clinicians to contact current and former patients about new advancements in genetics that may be relevant to the patient.
For Physicians: Cancer Genetic Counselors Enhance Your Practice
Links to more information on hereditary cancer syndromes: