In Genetic Testing for Breast Cancer Risk, Less May be More

PHILADELPHIA (April 13, 2017) – Genetics experts from Fox Chase Cancer Center are calling for more caution around how doctors assess genetic testing information for patients’ genetic predisposition to breast cancer risk. In an editorial appearing online in JAMA Oncology, Elias Obeid, MD, MPH, Michael Hall, MD, MS, and Mary Daly, MD, PhD, all members of the Cancer Prevention and Control Program, reviewed a new study by researchers at another institution, and praised it for identifying several genes that are currently tested, but which may lead to confusing or inconclusive guidance for breast cancer patients.

“The most important finding of this research is the lack of association identified between some of the moderate-risk genes that appear on breast cancer multigene panel tests and breast cancer risk,” they write. The concern is that, while testing women with breast cancer for a wide range of genetic mutations has become a routine part of medical care, and is helpful, in some instances the information the tests uncover might not benefit some patients and could be a source of uncertainty to the patient or her doctors.

The authors are supportive of genetic testing, writing that it can, “guide patients and health care professionals in planning cancer surgery, chemotherapy treatment, screening, and prevention.” But they conclude that further studies should determine more conclusively whether several genes currently tested, but identified as moderate and low risk, are significantly associated with cancer. If not, the group believes they can safely be excluded from most multigene panel tests for women with breast cancer.

They would also like to see better research studies that would improve the understanding of how clinicians can help patients manage risks uncovered by newly widespread genetic testing.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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