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Bookmark and Share Novant Health Cancer Risk Clinic – Translating powerful discoveries into empowering advice
By: Ilan Avin, MD, medical director, Novant Health Cancer Risk Clinic and Christen Csuy, CGC, genetic counselor, Novant Health Cancer Risk Clinic

Angelina Jolie recently announced that she decided to undergo preventive double mastectomy when she was found to have a genetic mutation that put her at a very high risk of developing breast and ovarian cancer. Her story has many people asking whether they might also harbor such a mutation. While only about 10 percent of cancer is due to a faulty gene inherited from parents, those affected can develop cancers at an earlier age, in multiple sites and can pass that risk on to their children. The good news is that we live in a medically advanced era where the struggle against cancer and many of these genetic mutations can be identified with blood or saliva-based testing. More importantly, those who are affected can take control to reduce their risk.

The Novant Health Cancer Risk Clinic can offer these patients a personalized plan that may include specialized screening programs, advice about preventive medication and risk-reducing surgery options.

Mother and daughterHow might this clinic work for a hypothetical patient? Let’s say you have a first-degree relative (such as your mother, sister or daughter) who is diagnosed with breast cancer at age 40. You visit the clinic and meet with a genetic counselor. After weighing the pros and cons of testing, you and that family member decide to get tested. Let’s say she tests positive for a BRCA1 mutation. Now imagine that you test positive for the same mutation. You now know your lifetime risk of breast cancer is not the average 12 percent but about 85 percent, and your risk of ovarian cancer is not the average 1.5 percent but rather 40 percent.

Armed with this powerful information, you now know that the normal lifestyle changes that reduce risk for other women may not be enough for you. You could undergo preventive mastectomies with breast reconstruction or oophorectomy (removal of the ovaries) and salpingectomy (removal of the Fallopian tubes) once you are finished having children. Having both of these surgeries would reduce your risk of breast cancer by about 90 percent and ovarian cancer by about 95 percent.

Now let’s imagine a few twists on this scenario. Let’s say your affected family member is positive for a BRCA mutation but you test negative. Imagine the relief of knowing that you are not at increased risk for breast and ovarian cancer.

Hereditary breast and ovarian cancer is just one example of a hereditary cancer syndrome, but there are many others. For example, some people who have many colon polyps or a strong family history of colon cancer may have inherited conditions such as Familial Adenomatous Polyposis (FAP) or Lynch Syndrome. These genetic conditions not only place them and their families at high risk for colon and rectal cancer, but may also increase their risk for cancer in other areas of the body such as the uterus, ovaries, stomach, small intestine, thyroid or brain. A specially trained team can help detect these complex patterns of family history, and those affected individuals can now benefit from specialized surveillance programs that might catch cancers at an earlier stage or recommend treatments to help prevent them.

As you can see, this is an exciting time in our efforts to understand, prevent and cure cancer! The team of specialists at the Novant Health Cancer Risk Clinic translates today’s powerful discoveries into empowering advice and real benefits for patients and their families.

Find out if you’re a candidate for our cancer risk clinic