This article reviews the types of genes included in multigene panels for breast cancer, and the risks associated with those genes.
Mary Alison Smania, DNP, FNP-BC, AGN-BC, FAANP
Mary Alison Smania, DNP, FNP-BC, AGN-BC, FAANP, is a board-certified family nurse practitioner and advanced genetics nurse and assistant professor, Health Programs, at Michigan State University College of Nursing in East Lansing.
The study of genetics and breast cancer has rapidly advanced in the past decade. Genetic testing used to look at only 1 or 2 genes, but now panel, or multigene, testing is available.
With estimates of approximately 252,000 new breast cancer diagnoses every year and 3.5 million breast cancer survivors,1 oncology nurses should assess whether patients are candidates for genetic testing for both their family members and themselves.
As essential members of the healthcare team, oncology nurses can identify patients who may be at risk for a genetic mutation and can significantly improve care for these patients and their families. Up to 10% of those diagnosed with breast cancer may have a genetic mutation.
MULTIGENE PANEL TESTING
The 2 most common genetic mutations associated with breast and ovarian cancer, BRCA1 and BRCA2, were identified almost 20 years ago. Since then, research and improvements in genetic testing have found mutations in other genes that are associated with breast cancer.
Next-generation sequencing has increased the ability to iden­tify several genes in a short period. Although these genetic mutations are much less common and do not seem to increase risk as much as BRCA1 and BRCA2, it is still important to iden­tify the risk and potential impact on patients and families.
Many testing facilities offer multigene panels for breast cancer risk. Below are some of the genes that are included in multigene panels for breast cancer:
WHO SHOULD ONCOLOGY NURSES REFER FOR TESTING?
Genetic testing can help patients understand and make import­ant risk-reducing surgical decisions or consider therapies indi­cated for those diagnosed with metastatic breast cancer, such as PARP inhibitor therapy. In addition, genetic testing for the patient can help with determining if other family members should also have testing and take steps to decrease their risk. Consider referring patients with 1 or more of the following:
Assessing patients for breast cancer risk begins with gathering their personal and family histories. Determine if the patient is at risk, and if they are, refer them for testing. Along with evalua­tion for risk, it is essential to explain to the patient why genetic testing can guide treatment, potentially saving the lives of the patient and their family members.
REFERENCES
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