ROLE OF BRCA1 MUTATION SCREENING IN THE MANAGEMENT OF FAMILIAL OVARIAN-CANCER

Families with multiple cases or ovarian cancer have long been observed , and in the past prophylactic oophorectomy has been advocated for wom en with a history of ovarian cancer in two first-degree relatives. It is now thought that >90% of familial ovarian cancer is due to inherite d mutations in the BRCA1 breast-ovarian cancer susceptibility gene on chromosome 17q. BRCA1 testing is being performed in several academic m edical centers on a research basis and is also now commercially availa ble. With the ability to identify inherited mutations in BRCA1, prophy lactic oophorectomy and other interventions intended to decrease cance r mortality can be offered specifically to women who carry a mutation, but the optimal strategy for decreasing cancer mortality in BRCA1 fam ilies has not yet been determined. To facilitate further clinical and basic research in this field, our group and others have established mu ltidisciplinary hereditary breast-ovarian cancer clinics that offer a wide range of services including BRCA1 testing, genetic counseling, an d cancer prevention and treatment.