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TUESDAY, Aug. 20, 2019 (HealthDay News) – Mutations in two genes – BRCA1 and BRCA2 – are known to significantly increase the risk of breast cancer, but experts have long debated which women should be tested.
The new recommendations of the US Prevention Services Working Group (USPSTF) can help clarify who can benefit most from a risk assessment test. Now, if a woman is at high risk, the task force recommends that she see a genetic counselor and possibly be screened for BRCA mutations.
"Breast cancer is widespread, but BRCA's fundamental mutations are rare and occur in less than 1% of women," said Dr. Carol Mangione, a member of the working group, professor of medicine and public health at the University of Toronto. the University of California Los Angeles. .
Deciding whether a test for these mutations is necessary is "a complex decision with lots of pros and cons," she said. "Women who are known to be positive subscribe to fairly dramatic surgeries and drugs."
For example, women with a BRCA gene mutation may have both breasts removed to prevent cancer development.
"In women who have no increased risk [of a BRCA mutation], the potential disadvantages outweigh the benefits of testing, "Mangione said.
The latest USPSTF recommendations regarding the BRCA test were published on August 20 in Journal of the American Medical Association.
So who should have this initial risk assessment?
According to the working group, it is suitable for women with a personal or family history of these cancers:
- breast
- ovarian
- Fallopian tube
- Peritoneal (the tissue lining the abdomen).
Women with ancestry related to BRCA mutations, such as those of Ashkenazi Jewish origin, should also be the subject of a risk assessment, said the working group.
Other groups likely to have an increased risk of BRCA gene mutation due to ancestry include African Americans, Mexicans, Nigerians and Indians, according to an editorial published Aug. 20 in JAMA Network open now. Its lead author is Dr. Padma Sheila Rajagopal from the University of Chicago.
Depending on the results of a risk assessment, a woman may not be counseled or undergo genetic testing. It is also possible that a woman receives genetic counseling and then decides that the BRCA test would not be of any benefit to her.
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