Dr. Judy Garber on genetic testing for BRCA / Dana-Farber Cancer Institute

Actress Angelina Jolie stunned the world with her Op-Ed in The New York Times, in which she shared her very private decision to have a preventive double mastectomy after testing positive for the BRCA1 gene mutation. But for Jolie, and many others, getting genetic testing and taking action may offer control and comfort. Judy Garber, MD, MPH, is director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, and one of the leaders of the Institute's Susan F. Smith Center for Women's Cancers. She talks about the BRCA test, family history and cancer risk, and preventive options for breast and ovarian cancer. Learn more about the Cancer Genetics and Prevention Program at http://www.dana-farber.org/Adult-Care... Transcription: This test is a blood test, so it’s a pretty easy test to have. Almost everyone who recommends this test believes it should be performed with genetic counseling, so that women understand when they have their testing what they’re doing, what kind of information they’re going to receive, and what the implications of a positive or negative test might be. The question is really is, “Do you have the kind of family history or personal history that makes it possible that a BRCA1 or BRCA2 or other mutation might be present?” If you were found to have high risk of breast and ovarian cancer (and if you read Angelina’s piece, she’s very clear that the risks are much higher than the general population), would you be willing to do the kinds of things that would be recommended? They include much more careful monitoring—mammograms and breast MRIs and examinations on a regular basis, trying to find these cancers early for breast cancer, considering surgery to reduce risk, considering other strategies. Actually removing the ovaries can lower breast cancer risk, and since we have no good early detection for ovarian cancer, we often have to recommend women have their ovaries and fallopian tubes removed. It depends where in your life you are when you learn that you have this risk. Have you had your children yet? Have you even had a partner yet? Have you finished your family and you're ready to consider this? Have you seen cancer up close and you just don’t want to go there? And what are you willing to do? I’m seeing most people these days contact their primary care physician or their gynecologist. They're either tested by those physicians or they're referred to a center that does testing. If they’re positive, we hope they’ll all be seen in specialized centers, because in this area we have them, and we hope that we make women’s lives better, even if they have to go with a difficult diagnosis.