Knowledge is Power
There are many risk factors associated with breast and ovarian
cancer. They include a family history,
age and reproductive history. One of these
factors or a combination of them can be a cause
of concern for many women. For those women
who want to learn more about their risk for
breast and ovarian cancer, the Joan Karnell
Cancer Center at Pennsylvania Hospital offers
the Cancer
Risk Evaluation Program.
Lisa B. Aiello, RN, MSN, a genetic oncology advanced practice nurse,
coordinates the program for the Joan Karnell Cancer Center. “The
purpose of the program is not to give women a dark cloud,” said
Aiello. “Rather it is a means of empowering them by helping
them understand the risk factors and providing them with a plan to
protect their health.”
There are several steps involved in the program. The first is the
completion of history and risk factor questionnaires, prior to the
first appointment. During the first appointment Lisa reviews the questionnaires
and gathers additional information. She counsels the woman on issues
such as genes, inheritance, genetic testing, insurance discrimination,
insurance coverage of testing, and confidentiality
The next step involves a comprehensive evaluation by a group of professionals
from oncology and genetics at the Abramson
Cancer Center of the University of Pennsylvania. Lisa presents
each new patient’s case to the group. The specialists assess
the patient’s eligibility for participation in research, risk
assessment, genetic testing and makes recommendations for follow-up.
Following the evaluation, the patient is contacted with the results
and scheduled for a second appointment. Complementing this multi-disciplinary
approach is an extensive clinical research program.
During the second visit, patients meet with Lisa and Dr.
Bernard A. Mason, a medical oncologist at Pennsylvania Hospital,
to discuss the results of the comprehensive evaluation and answer
questions. If genetic testing is recommended, Dr.Mason and Lisa
counsel patients about the benefits and limitations of the testing
to help them make an informed decision. Genetic testing is offered
for people with personal or strong family histories of breast and/or
ovarian cancer to determine the likelihood that they will get cancer.
Testing consists of a simple blood test.
No matter what the patient’s level of risk, the Cancer Risk
Evaluation team develops a personalized plan of careful monitoring.
This may include a schedule of periodic mammograms or other specialized
testing. Lisa notes that the advancements in cancer detection and
treatment are constantly changing. For this reason the program maintains
a patient database. “If there is a new drug or new method of
cancer prevention/ early detection, we can contact our patients who
may benefit and provide them with the information,” said Lisa.
Risk evaluation does not guarantee that a patient will not develop
cancer. However, for those patients who already are at risk, cancer
risk evaluation empowers them to take an active part in reducing that
risk.
The Cancer Risk Evaluation Program also evaluates patients for a
risk of sarcomas, gastrointestinal cancers such
as colon or rectal and other cancers. For more
information about the Cancer Risk Evaluation
Program at Pennsylvania Hospital, call 1-800-789-PENN
(7366).
The following factors may increase the risk of breast cancer:
- Risk increases as you age
- Family history of breast cancer
- BRCA 1 or BRCA 2 gene mutations
- First period before age 12 or menopause after age 50
- No children or having children after age 30
- Birth control pills or hormone replacement therapy may slightly
increase risk
- Prior history of breast biopsies or biopsies that revealed LCIS
or atypical ductal hyperplasia
The following factors may increase the risk of ovarian cancer:
- Risk increases as you age
- Family history of ovarian cancer
- BRCA 1 or BRCA 2 gene mutations
- No children
- History of infertility or of taking infertility drugs
- Prior use of talcum powder in the groin area (at one point, talcum
powder contained asbestos)
The following features in a family may indicate the need for a
genetic evaluation:
- Multiple breast cancers in the family, occurring
under age 50
- Ovarian cancer in the family
- Both breast cancer and ovarian cancer in the same woman
- Bilateral breast cancer
- Male breast cancer
- Ashkenazi Jewish ancestry
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