A game changer in assessing the risk of breast, ovarian cancer

• Genetics and cancer risk

Genetics and cancer risk

Talk about it

New tests to determine a woman’s genetic risk for breast cancer are giving health care providers the information they need to intervene early and treat the disease.

Genetic risk assessment is a new development for Hereditary Breast and Ovarian Cancer Syndrome, said Anne Nygaard, family nurse practitioner at the Altru Cancer Center in Grand Forks.

The HBOC syndrome is caused by an alteration or mutation of BRCA1 and BRCA 2 genes. These mutations can be inherited from one’s mother or father.

In breast cancer, about 5 to 10 percent are hereditary breast cancers, Nygaard said. Certain populations are more likely to have the hereditary mutation, including people with Ashkenazi Jewish ancestry.

BRCA testing “is really an expanding area in breast cancer,” she said. “If we can identify the women who have this by doing genetic testing, we can reduce their risk by medical or surgical options.”

Medical options would include prescribing the medication tamoxifen and birth control drugs between pregnancies, she said.

Surgical options would include hysterectomy, removal of reproductive organs, or bilateral mastectomy, removal of the breasts.

“My job is to look at family and personal history and counsel (patients) on the risks and benefits of (BRCA) testing,” Nygaard said, “to help them make an informed decision.”

“The majority of women do want to know” if they have the syndrome, she said, “because there are things they can do to reduce the risk of developing it” and results can lead to early detection.

“Whether or not someone has the BRCA mutation can be determined in their 20s,” she said.

For women who have the gene mutation the risk of developing breast cancer is up to 87 percent, compared to 8 percent in the general population.

Their risk of developing ovarian cancer is up to 44 percent, compared to less than 1 percent in the general population.

Breast cancer risk

Women tend to overestimate their chances of having the hereditary mutation, Nygaard said. “But just because they’re negative for BRCA, they’re still at risk for breast cancer based on family or personal history.”

About 20 percent of breast cancers are “familial,” and are related to something they grew up with, something in the environment, or a lifestyle that presents a potential cause, she said.

“One of eight women will develop breast cancer,” she said, “usually in their 70s or 80s.”

On average, 552 women were diagnosed with breast cancer and 89 women died each year from 2005 to 2009, according to the North Dakota Statewide Cancer Registry.

Most cancers, called “sporadic,” occur by chance, Nygaard said. Typically, no one else in the family has been diagnosed with breast cancer.

The disease is “overwhelming,” she said. “There’s so much knowledge, so many new things coming out. So much information you have to share with people.

“There are so many rare syndromes out there. But BRCA is the most common. That’s why we focus on it.”

Nationwide ,efforts to increase awareness and promote early detection of breast cancer seem to be effective.

“We’re finding it earlier and catching it at earlier stages,” Nygaard said. “People are more educated.”

She urges women to talk to their health care providers about breast cancer.

“Getting mammograms beginning at age 40 is important,” she said. “Having knowledge empowers you. You’re more likely to prevent it. Education is key.”

Research is also critical to developing effective treatments.

The Altru Cancer Center is involved in cancer research, connected to the Mayo Clinic in Rochester, Minn., and can enroll patients in investigational studies, Nygaard said, “much of it is related to comparing chemotherapies.”

Patients can be referred to the Altru Cancer Center by their family physician or obstetrics-gynecologist or they can come in on their own.

Talking about Hereditary Breast and Ovarian Cancer Syndrome

• When: 5:30-6:30 p.m. Tuesday. Oct. 30

• Where: Community Room at Choice Health & Fitness, 4401 S. 11th St., Grand Forks.

• Admission: Free and open to the public. No registration necessary.

Call Knudson at (701) 780-1107; (800) 477-6572, ext. 1107; or send e-mail to pknudson@gfherald.com.

Tags: altru health system, gf and egf, accent, health, cancer