Risk
Factors for Inherited Breast and/or Ovarian Cancer:
-
Multiple
cases of breast cancer (particularly where diagnosis occurred at less
than 50 years) and/or ovarian* cancer (any
age) in the family - especially in closely related relatives in more
than one generation.
-
Age
at diagnosis of breast cancer less than 35 years.
-
A
family member diagnosed with both breast and ovarian* cancer.
-
Breast
and/or ovarian* cancer in Jewish families.
-
Family
member(s) with primary cancer occurring in both breasts, especially if
one or both cancers were diagnosed before age 50.
-
A
family member diagnosed with invasive serous ovarian* cancer.
-
Presence
of male breast cancer in the family.
-
Family
member with an identified BRCA1 or BRCA2 mutation.
-
Presence
of other associated cancers or conditions suggestive of an inherited
cancer syndrome.
*includes
cancer of the Fallopian tubes and primary peritoneal cancer
-
Multiple
cases in the family of cancers related to the Hereditary Non-Polyposis
Colorectal Cancer (HNPCC) spectrum with at least one relative affected
with colorectal or endometrial cancer. An age of onset less than 50
years, in closely related relatives and in more than one generation
would raise the index of suspicion.
Note: Cancers related to the HNPCC spectrum include: colorectal,
gastric, small bowel, hepatobiliary,
pancreatic, endometrial,
ovarian, kidney, ureter, sebaceous carcinoma of the skin and brain
cancers.
-
Age
at diagnosis of colorectal cancer less than 35 years.
-
Multiple
primary cancers in one family member (see 1. above for tumour sites).
-
Family
member with Familial Adenomatous Polyposis (FAP), or 10 or more
histologically confirmed adenomatous polyps (suggestive of attenuated
FAP).
-
Family
member with a colonic adenoma or cancer with high microsatellite
instability (MSI).
-
Family
member with a known mutation causing either HNPCC or FAP.
Genetic
Testing:
Genes
for the hereditary forms of breast and ovarian cancer, and colorectal
cancer have been identified in the past several years. Testing for these
genes is now possible in certain clinical situations.
Genetic
testing is offered only to families that meet criteria for genetic
testing, and in most cases will be offered to a family member affected
with cancer first. If a mutation is detected, testing will then be
available to unaffected members. If affected family members are
unavailable for testing, only in exceptional circumstances will genetic
testing be offered to an unaffected individual. The specific criteria for
eligibility for genetic testing are available from your local genetics
center or familial cancer clinic, or the Nov. 2001 issue of the Ontario
Medical Review (available on-line at www.oma.org).
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