Klin Onkol 2006; 19(Suppl): 101-104.
Summary
Prevention in women with hereditary predisposition to breast and ovarian cancer is a complex process where physicians with different specialization participate. The risk of breast cancer is ten times, the risk of ovarian cancer may be thirty times higher than the risk of general population. Genetic testing of BRCA1/2 predisposition genes is routinely done in the Czech Republic. Predictive testing of healthy relatives may prove or exclude the hereditary risk of the disease and direct the special prevention only to the mutation carriers.
In the questionnaire study we examine the psychosocial influence of genetic counselling and testing, evaluate the level of preventive care and the use of prophylactic surgeries.
The high-risk clinic at Masaryk Memorial Cancer Institute follows 387 individuals with proven or suspected hereditary predisposition to cancer, from those are 85 patients, 206 healthy women and 19 men positively tested for BRCA mutations. Prevention follows the recommendations for standard preventive care in carriers, but is individualized according to the specific features of family history. Preventive adnexectomy after 40 years of age was accepted by 12 of 27 (44,4%) of healthy BRCA carriers, 14 of 35 (40%) of patients with breast cancer. Prophylactic mastectomy was carried out in 10 from 70 (14,3%) healthy BRCA carriers and 12 of 50 (24%) patients with breast cancer. Magnetic resonance imaging of breasts is provided to carriers yearly from 20 years of age.
