Management of genetic syndromes predisposing to gynecologic cancers.

Document Type

Article

Publication Date

3-1-2013

Institution/Department

Oncology

Journal Title

Current treatment options in oncology

MeSH Headings

BRCA1 Protein, BRCA2 Protein, Breast Neoplasms, Chemoprevention, Colorectal Neoplasms, Hereditary Nonpolyposis, Female, Genetic Counseling, Genetic Predisposition to Disease, Genetic Testing, Genital Neoplasms, Female, Health Knowledge, Attitudes, Practice, Humans, Hysterectomy, Ovariectomy, Salpingectomy

Abstract

Women with personal and family histories consistent with gynecologic cancer-associated hereditary cancer susceptibility disorders should be referred for genetic risk assessment and counseling. Genetic counseling facilitates informed medical decision making regarding genetic testing, screening, and treatment, including chemoprevention and risk-reducing surgery. Because of limitations of ovarian cancer screening, hereditary breast and ovarian cancer-affected women are offered risk-reducing bilateral salpingo-oophorectomy (BSO) between ages 35 and 40 years, or when childbearing is complete. Women with documented Lynch syndrome, associated with mutations in mismatch repair genes, should be screened at a young age and provided prevention options, including consideration of risk-reducing total abdominal hysterectomy and BSO, as well as intensive gastrointestinal screening. Clinicians caring for high-risk women must consider the potential adverse ethical, legal, and social issues associated with hereditary cancer risk assessment and testing. Additionally, at-risk family members should be alerted to their cancer risks, as well as the availability of risk assessment, counseling, and treatment services.

ISSN

1534-6277

First Page

34

Last Page

50

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