Consider genetic testing for hereditary cancers.(Gynecology)

WASHINGTON -- Clinical genetic testing for the BRCA1 and BRCA2 genes allows physicians to more precisely identify who is at high risk for certain cancers, Dr. Karen H. Lu said at the annual meeting of the American College of Obstetricians and Gynecologists.

Armed with this knowledge, physicians can recommend risk-reducing strategies including prophylactic surgery, said Dr. Lu, associate professor of gynecologic oncology and co-clinical medical director of the Clinical Cancer Genetics program at the MD Anderson Cancer Center in Houston.

For example, performing a bilateral salpingo-oophorectomy in someone who is a BRCA mutation carrier decreases their risk for ovarian cancer by 85%-95%, she said.

"In someone who is at such high risk for developing a disease for which we have no current effective screening, performing this surgery effectively saves their lives," Dr. Lu said.

In terms of breast cancer management, a 35-year-old woman with breast cancer and a strong family history might otherwise be advised to undergo a lumpectomy, radiation, and chemotherapy.

However, if she knew she carried either a BRCA1 or BRCA2 mutation, she might choose to undergo a bilateral mastectomy with reconstruction upfront to decrease her risk of developing a second cancer, Dr. Lu said.

Physicians can identify women who may be good candidates for genetic testing by asking a few targeted questions during the annual visit, Dr. Lu said.