The New York Times recently reported on new research findings The research was conducted on an Ashkenazi Jewish group in Israel and asserts that some women who tested positive for cancer-causing genetic mutations during random screenings may have higher rates of breast and ovarian cancer even when they have no family history of the disease.
Gene mutations in either BRCA1 or BRCA2 place individuals at higher than average risk for developing certain cancers, most notably breast and ovarian cancer. Inherited mutations in the genes BRCA1 and BRCA2 are rare — only about 1 in 500 to 1 in 800 individuals have a mutation. However, individuals of Ashkenzi Jewish ancestry have a 1 in 40 chance of carrying a BRCA gene mutation.
Even with recent research, there is still general disagreement about cancer risk in families who have BRCA mutations but no known family history of cancer. Although some now think that all women should be screened, others advise against routine genetic counseling and testing for women whose family history doesn't indicate a risk of harmful mutations. Due to this uncertainty, some women may find themselves facing difficult choices, such as opting for surgery when they may not need to.
Susan Domchek, MD, executive director of the Basser Research Center for BRCA at the University of Pennsylvania's Abramson Cancer Center, commented in the article on the psychological and social impact on patients who test positive for BRCA mutations: “These are not trivial,” she said. “They have the potential to cause harm.”
It's worth noting that this research was done in an Ashkenazi Jewish group in Israel and not in a general US population group. We know that Ashkenazi Jews have a much higher chance of carrying a BRCA mutation than those of other ethnic groups.
When to Consider Genetic Counseling
In a family with a significant history of breast and/or ovarian cancer, the first step is to seek genetic counseling with an expert. Genetic counseling will help determine the best approach to testing in your family.
Consider genetic risk evaluation for BRCA testing if:
You or a family member has had:
- Breast cancer at age 50 or younger
- Ovarian or fallopian tube cancer at any age
- Cancer in both breasts
- Male breast cancer
- Breast cancer and are of Ashkenazi Jewish ancestry
You have two or more family members with any of the following cancers:
- Breast cancer
- Ovarian or fallopian tube cancer
- Pancreatic cancer
- Prostate cancer (at least one diagnosed under age 60)
Educational Events and Resources for Cancer Risk Evaluation and Genetic Screening
Join the Basser Research Center for BRCA, the Program for Jewish Genetic Health and the JCC in Manhattan for Testing for Cancer Risk in the Jewish Population: A Community Conversation on Monday, November 3 at 7:30 p.m. at the JCC in Manhattan.
Amy Harmon, a Pulitzer Prize winning New York Times journalist, will moderate a panel of medical experts in a lively discussion about testing for BRCA mutations in the Jewish community. She also will engage the audience in a conversation about the controversial topic of population testing all Ashkenazi Jews for these mutations. Read more information and RSVP online.
Visit the Basser Site