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Joining FORCES is the FORCE newsletter with news, views and supportive information for individuals concerned about hereditary breast and ovarian cancer.

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Current Testing Landscape

All Women with Ovarian Cancer Meet Expert Guidelines for Genetic Testing

by Katrina Altersitz Wells and Lisa Rezende, PhD

National Comprehensive Cancer Network (NCCN) guidelines recommend genetic testing be considered for all patients with invasive ovarian cancer. We can do a better job of assuring that all people who meet these guidelines have the opportunity to undergo genetic counseling and/or testing.

Various studies have determined that 15%-25% of ovarian, fallopian tube, and peritoneal cancers are associated with BRCA mutations. Previous studies have shown that genetic testing was not pursued in many ovarian cancer cases due to an individual's lack of family history of breast or ovarian cancer and/or older age at onset. A study published in 2014 in the Journal of Clinical Oncology found that the popular BRCAPro tool used to estimate a person's risk of carrying a BRCA mutation may underestimate the risk for many women who already have ovarian cancer. This study looked at 589 patients, 31% of whom tested positive for a BRCA1 or BRCA2 mutation. Almost half of those patients had BRCAPRO scores that would not suggest the presence of a BRCA mutation.

Studies such as these, combined with the recent approval of the drug Lynparza for use in ovarian cancer patients with BRCA mutation who have had three prior lines of chemotherapy, reinforce the need for testing all ovarian cancer patients. If you or a family member has been diagnosed with ovarian cancer, please see a genetics expert to discuss if genetic testing is right for you.

Reference: Daniels, MS, Babb, SA, King, RH, et al., "Underestimation of Risk of a BRCA1 or BRCA2 Mutation in Women With High-Grade Serous Ovarian Cancer by BRCAPRO: A Multi- Institution Study," Journal of Clinical Oncology, Vol. 32, No. 12, pp. 1240-1255 (2014).

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