Are you at risk for hereditary cancers?

Genetic Counselling

Topic: Diagnosis & Treatment

Are you at risk for hereditary cancers? We asked genetic counsellors Karen Ott and Talia Mancuso to help explain the ABCs of BRCA.

The good news is that very few people inherit the mutation that increases the risk of breast and ovarian cancers. Only five to 10 percent of breast and ovarian cancers are hereditary. “And being told you have the mutation is not a cancer diagnosis,” says Talia Mancuso of Sunnybrook Odette Cancer Centre in Toronto. “In fact, we all carry the BRCA gene, whether we are male or female,” says Mancuso’s colleague Karen Ott. “BRCA1 and BRCA2 work in a similar pathway in that you see an increased breast and ovarian cancer risk. We treat and counsel them the same way.”

The process of counselling is diagnostic (the actual estimation of risk) and supportive (helping people understand and adapt to the medical, psychological and familial implications). If genetic counselling discovers the mutation, it means that an individual has a higher than average risk for specific cancers, such as breast and ovarian.

Genetic counsellors help support families that may carry the mutation. “We use the family tree as a map,” says Ott. While learning that you are at risk may be a shock at first, in the long run it could lead to early detection, which can save your life. “We believe knowledge is power,” says Mancuso. Which is why you should talk to your family and health care provider if your family has risk factors for the BRCA mutation.

If you’ve had a cancer diagnosis before genetic counselling, discovering the presence of the mutation changes a patient’s treatment options. “Each patient has a different story and would be advised differently,” says Ott. Because of the increased risks, prophylactic surgery would also be discussed.
If you haven’t had a cancer diagnosis, counsellors may recommend a more aggressive program of mammograms and breast MRIs than the general population. Depending on the patient’s age as well as personal and family histories, a counsellor will also discuss preventive options such as prophylactic mastectomies and oophorectomies (removal of the ovaries). “Our focus is on prevention,” says Mancuso.

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