The potential for genetic medicine to give early warning to women who are at risk of developing breast cancer was discussed recently at the latest Grand Rounds hosted by Weill Cornell Medicine – Qatar (WCM-Q).
Dr Jeremie Arash Rafii Tabrizi, Associate Professor of Genetic Medicine in Obstetrics/Gynaecology at WCM-Q, said that genetic mapping can determine if a woman has a mutation in either of two specific genes, named BRCA1 and BRCA2. Harmful mutations in either of these genes carry significantly increased risk of breast and ovarian cancer.
Dr Tabrizi said that early testing for the BRCA1 an BRCA2 genes can be extremely useful, allowing doctors to help patients make interventions to reduce their risk of developing breast or ovarian cancer, and to take steps to preserve their ability to have children. Dr Tabrizi is advocating for all women being tested for BRCA1 and BRCA2 mutations at an early age, either in their late teens or early 20s.
Our wish is to give women maximum control over their own bodies and their future, and early testing provides this far more effectively than a late diagnosis and the invasive procedures that follow.’
Interventions include drug therapies and lifestyle changes but the only truly effective intervention for breast cancer is bilateral mastectomy, which reduces risk by approximately 90%, but is invasive and traumatic. Similarly, the most effective intervention for ovarian cancer is surgical removal of the ovaries. However, Dr Tabrizi said recent research has suggested most ovarian tumors actually begin in the fallopian tubes and that their removal could also be an effective intervention.
Dr Tabrizi also said that breast and ovarian cancer risk before the age of 30 is relatively low, even for carriers of BRCA1 and BRCA2 mutations.
This means that a woman who is tested early and discovers she has BRCA1 or BRCA2 mutations can think about what she wants to do for quite a long time, make plans for the interventions she feels are right for her in a calm and considered way, speak with her family and partner, and take action to preserve her ability to have children by having her oocytes (eggs) frozen.’
Dr Tabrizi added that while people might be afraid of knowing their genetics, it could save their life if appropriate preventive measures are initiated early. The role of physicians, according to Dr Tabrizi, is to educate people so that genetic information is clearly understood.
The lecture was accredited locally by the Qatar Council for Healthcare Practitioners-Accreditation Department (QCHP-AD) and by the Accreditation Council for Continuing Medical Education (ACCME).
For more information, visit the WCM-Q website at qatar-weill.cornell.edu.