| Cancer | Genetic Cancer Risk |
|---|---|
| Female Breast | High Risk |
| Ovarian | High Risk |
| Male Breast | Elevated Risk |
| Pancreatic | Elevated Risk |
| Prostate | Elevated Risk |
| Cancer Type | Age Range | Cancer Risk | Risk for General Population |
|---|---|---|---|
| Female Breast | To age 503, 4, 5, 6 | 28%-51% | 1.9% |
| To age 704, 5, 6, 7 | 46%-87% | 7.1% | |
| Second primary within 5 years of first breast cancer diagnosis8, 9, 10, 11 | 8.9%-20% | 2% | |
| Ovarian | To age 503, 5, 6, 9 | 8%-23% | 0.2% |
| To age 703, 4, 5, 6 | 39%-63% | 0.7% | |
| Ovarian cancer within 10 years of a breast cancer diagnosis11, 12 | 12.7% | <1.0% | |
| Prostate | To age 706, 13, 14 | Up to 16% | 6.6% |
| Male Breast | To age 706, 15 | 1.2% | <0.1% |
| Pancreatic | To age 806, 16 | Elevated risk | 1% |
The overview of medical management options provided is a summary of professional society guidelines. The most recent version of each guideline should be consulted for more detailed and up-to-date information before developing a treatment plan for a particular patient.
This overview is provided for informational purposes only and does not constitute a recommendation. While the medical society guidelines summarized herein provide important and useful information, medical management decisions for any particular patient should be made in consultation between that patient and his or her healthcare provider and may differ from society guidelines based on a complete understanding of the patient’s personal medical history, surgeries and other treatments.
| Cancer Type | Procedure | Age to Begin | Frequency (Unless otherwise indicated by findings) |
|---|---|---|---|
| Female Breast | Breast awareness - Women should be familiar with their breasts and promptly report changes to their healthcare provider. Periodic, consistent breast self-examination (BSE) may facilitate breast awareness.2 | 18 years | NA |
| Clinical breast examination2 | 25 years | Every 6 to 12 months | |
| Breast MRI with contrast and/or mammography with consideration of tomosynthesis2 | Age 25 for MRI, or if MRI is unavailable, mammography with consideration of tomosynthesis. Age 30 for both MRI and mammography. Individualize to a younger age if a relative has been diagnosed younger than age 30. | Annually | |
| Consider investigational screening studies within clinical trials.2 | Individualized | NA | |
| Consider risk-reducing mastectomy.2 | Individualized | NA | |
| Consider options for breast cancer risk-reduction agents (i.e. tamoxifen).2 | Individualized | NA | |
| Ovarian | Bilateral salpingo-oophorectomy, considering both the possible increased risk for serous uterine cancer and the possible advantages of hormone replacement therapy with estrogen only2 | 35 to 40 years, upon completion of childbearing | NA |
| Consider transvaginal ultrasound and CA-125 measurement. Consider investigational screening studies within clinical trials.2 | 30 to 35 years | Individualized | |
| Consider options for ovarian cancer risk-reduction agents (i.e. oral contraceptives).2, 22 | Individualized | NA | |
| Prostate | Consider prostate cancer screening.1, 2 | 40 years | Individualized |
| Since mutation carriers are at an increased risk for more aggressive prostate cancer this information may be included as part of the risk and benefit discussion about prostate cancer screening.1, 24 | NA | NA | |
| Since mutation carriers are at an increased risk for more aggressive prostate cancer this information may be considered when choosing management options for men with a diagnosis of prostate cancer.1, 24 | NA | NA | |
| Male Breast | Breast self-examination2 | 35 years | Monthly |
| Clinical breast examination2 | 35 years | Annually | |
| Pancreatic | For patients with a family history of pancreatic cancer, consider available options for pancreatic cancer screening, including the possibility of endoscopic ultrasonography (EUS) and MRI/magnetic resonance cholangiopancreatography (MRCP). It is recommended that patients who are candidates for pancreatic cancer screening be managed by a multidisciplinary team with experience in screening for pancreatic cancer, preferably within research protocols.23, 25 | Age 50, or 10 years younger than the earliest age of pancreatic cancer diagnosis in the family | Annually |
| Provide education about ways to reduce pancreatic cancer risk, such as not smoking and losing weight.20, 23 | Individualized | Individualized | |
| For Patients With A Cancer Diagnosis | For patients with a gene mutation and a diagnosis of cancer, targeted therapies may be available as a treatment option for certain tumor types (e.g., platinum chemotherapy, PARP-inhibitors)17, 18, 19, 20, 21 | NA | NA |
The following information for Family Members will appear as part of the MMT for a patient found to have a mutation in the BRCA1 gene.
A major potential benefit of myRisk genetic testing for hereditary cancer risk is the opportunity to prevent cancer in relatives of patients in whom clinically significant mutations are identified. Healthcare providers have an important role in making sure that patients with clinically significant mutations are informed about the risks to relatives, and ways in which genetic testing can guide lifesaving interventions.
Parents who are concerned about the possibility of passing on a BRCA1 mutation to a future child may want to discuss options for prenatal testing and assisted reproduction techniques, such as pre-implantation genetic diagnosis (PGD).2