Hereditary cancers in obstetrics and gynecology.
The lack of information regarding the effectiveness of screening strategies, chemoprevention, or surgical prophylaxis, and the uncertainty regarding penetrance and risk modification has led many experts to recommend that genetic testing for BRCA1, BRCA2, and other cancer susceptibility genes be performed only in a research setting. Patients, however, are likely to increasingly request access to genetic testing and deserve up-to-date counseling about recent advancements in our knowledge. The primary care physician should concentrate on identifying women likely to be at high-risk for cancer for further referral, allowing the cancer genetics specialist to track down medical records, clarify the pedigree, discuss genetic testing, and provide access to the appropriate cancer specialist to discuss risk reduction.
Swisher
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University of Washington, Seattle, Washington, USA. swishere@u.washington.edu
D001943:Breast Neoplasms / Q000235:genetics; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005820:Genetic Testing; D005833:Genital Neoplasms, Female / Q000235:genetics*; D006223:Hamartoma Syndrome, Multiple / Q000235:genetics; D006801:Humans; D016864:Li-Fraumeni Syndrome / Q000235:genetics; D009386:Neoplastic Syndromes, Hereditary / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000235:genetics; D010580:Peutz-Jeghers Syndrome / Q000235:genetics; D012306:Risk