Screening for hereditary breast and ovarian cancer at outpatient imaging centers ‘highly feasible’

Large-scale screening for hereditary breast and ovarian cancer during an outpatient imaging encounter is practical and “highly feasible,” MD Anderson Cancer Center experts charged in a new analysis.

Pathogenic mutations in breast cancer genes have been shown to increase a patient’s lifetime risk of getting diagnosed with these two forms of the Big C. Yet use of genetic evaluation remains “suboptimal,” researchers wrote Monday in Cancer.

To address this challenge, the noted Houston-based provider developed a questionnaire using National Comprehensive Cancer Network genetic counseling referral guidelines. Administering the form as part of mammography intake at a community imaging center, physicians found success.

“This study shows that large-scale screening of patients for [hereditary breast and ovarian cancer] syndromes at time of breast imaging is practical and highly feasible,” Banu Arun, MD, with MD Anderson’s Department of Breast Medical Oncology and Clinical Cancer Genetics, and co-authors wrote Aug. 23. “The screening tool identified women with actionable BRCA1/2 mutations and mutation-negative but high-risk women, leading to significant changes in their risk management; these women would otherwise have been missed.”

MD Anderson screened nearly 35,000 patients with the questionnaire between 2012-2015. About 4% (or nearly 1,250) were eligible for referral for genetic counseling; 245 made an appointment, and 142 received the service. About 28% (0r 40 patients) had a personal history of breast cancer but never received genetic testing; 8% tested positive for a pathogenic mutation, while 9% had a variant of “unknown significance.

“Many” met the criteria for added breast MRI, with lifetime breast cancer risk greater than 20% stemming from family cancer history. And Arun et al. estimated that the intervention bolstered clinical risk management in 67% of those who received counseling.

Read the rest of the study, published by the American Cancer Society, here.

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