Panel: no routine screening for BRCA mutations.(Gynecology)

Women should not routinely undergo genetic screening or counseling for breast and ovarian cancer risk based on gene mutations unless they are at high risk, according to a first-time recommendation on this topic by the U.S. Preventive Services Task Force.

The task force, an independent panel of experts in prevention and primary care, recommended that primary care physicians not routinely refer women for genetic counseling or DNA testing for BRCA1 or BRCA2 gene mutations because harms and costs outweigh the benefits (Ann. Intern. Med. 2005;143:355-61).

However, the task force did recommend that women with a family history of breast or ovarian cancer undergo genetic screening for gene mutations if they are at increased risk.

Women who are at increased risk include those of Ashkenazi Jewish descent with a first- or second-degree relative with breast or ovarian cancer. Women not of this descent are at risk if they have family history patterns of breast and ovarian cancer (multiple first-and second-degree relatives).

According to the task force, only 2% of the general population is said to have BRCA gene mutations based on family history.

The task force recommendation estimated that between 1 in 300 and 1 in 500 women have the BRCA gene mutations in the general population, but not everyone with the mutations will develop breast or ovarian cancer.

Of women aged 70 years and younger with BRCA gene mutations, 35%-84% will develop breast cancer and 10%-50% will develop ovarian cancer, the task force noted.