title: Management of genetic syndromes predisposing to gynecologic cancers.
abstract: Women with personal and family histories consistent with gynecologic cancer-associated hereditary cancer susceptibility disorders should be referred for genetic risk assessment and counseling. Genetic counseling facilitates informed medical decision making regarding genetic testing, screening, and treatment, including chemoprevention and risk-reducing surgery. Because of limitations of ovarian cancer screening, hereditary breast and ovarian cancer-affected women are offered risk-reducing bilateral salpingo-oophorectomy (BSO) between ages 35 and 40 years, or when childbearing is complete. Women with documented Lynch syndrome, associated with mutations in mismatch repair genes, should be screened at a young age and provided prevention options, including consideration of risk-reducing total abdominal hysterectomy and BSO, as well as intensive gastrointestinal screening. Clinicians caring for high-risk women must consider the potential adverse ethical, legal, and social issues associated with hereditary cancer risk assessment and testing. Additionally, at-risk family members should be alerted to their cancer risks, as well as the availability of risk assessment, counseling, and treatment services.
authors: Cancer Risk and Prevention Program, Maine Medical Center Cancer Institute, Scarborough, ME 04074, USA. miesfs@mmc.org
authors: Susan
authors: S
authors: Miesfeldt
authors: Amanda
authors: A
authors: Lamb
authors: Christine
authors: C
authors: Duarte
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D018890:Chemoprevention; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics / Q000601:surgery; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D005833:Genital Neoplasms, Female / Q000235:genetics* / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007044:Hysterectomy; D010052:Ovariectomy; D058994:Salpingectomy
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human