Together We Can -- Newsletter of the Joan Karnell Cancer Center

Fall 2003

Technological Advancements in Treatment of Breast Cancer
PET Scan Techonology
Every Step of the Way
Knowledge is Power
Supportive Care Programs for Women with Breast Cancer
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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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Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.

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