Family history can trump breast cancer gene test - Yahoo! News

http://news.yahoo.com/s/ap/20081117/ap_on_he_me/med_breast_cancer_3

Family history can trump breast cancer gene test
By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer Mon Nov 17, 3:28 pm ET

WASHINGTON – If breast cancer runs in the family, women can be at high risk even if they test free of the disease's most common gene mutations, sobering new research shows. The genes BRCA1 and BRCA2 are linked with particularly aggressive hereditary breast cancer, and an increased risk of ovarian cancer, too.

When a breast cancer patient is found to carry one of those gene mutations, her relatives tend to breathe a sigh of relief if they test gene-free.

But those headline-grabbing genes account for only about 15 percent of all breast cancer cases. Even in families riddled with breast cancer, a BRCA gene is the culprit only in roughly one family of every five that gets tested, said University of Toronto cancer specialist Dr. Steven Narod.

So clearly members of those families remain at risk from other yet-to-be-found genes, but how much risk?

Narod tracked nearly 1,500 women from 365 breast cancer-prone families, who tested negative for BRCA1 and BRCA2 mutations.

After five years, those women had a fourfold higher risk than average women of developing breast cancer, Narod reported Monday at a meeting of the American Association for Cancer Research.

This is crucial information for women considering gene testing, said Georgetown University genetics counselor Beth Peshkin, who wasn't part of the study.

"This is contrary to what I think the common perception is," Peshkin said. "Unless a mutation is identified in the family, a negative test result doesn't provide reassurance."

The good news: Narod's study showed these women didn't have an increased risk of ovarian cancer, like BRCA1- and BRCA2-carriers do.

While the $3,000 BRCA tests are well-accepted, newer tests for other genes linked to breast cancer are coming on the market.

But "the family history is a much stronger predictor," stressed Narod. He recommends that such women take the anti-cancer drug tamoxifen and undergo MRI cancer checkups instead of easier mammograms "regardless of what other gene tests showed."

Oncology: percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy ....

http://www.qualitymeasures.ahrq.gov/summary/summary.aspx?ss=1&doc_id=12046

Oncology: percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address pain.

Cancer in Canada in 2008 -- Marrett et al. 179 (11): 1163 -- Canadian Medical Association Journal

http://www.cmaj.ca/cgi/content/full/179/11/1163?etoc#T122

Pandora's box: ethics of PGD for inherited risk of late-onset disorders

http://www.ncbi.nlm.nih.gov/pubmed/18983739?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk of hereditary breast ovarian cancer

A controlled observational study:

http://www.ncbi.nlm.nih.gov/pubmed/19008092?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

A serum based analysis of ovarian epithelial tumorigenesis

http://www.ncbi.nlm.nih.gov/pubmed/19007974?dopt=Abstract

Helping Doctors and Patients Make Sense of Health Statistics

http://www.psychologicalscience.org/journals/pspi/pspi_8_2_article.pdf">pspi_8_2_article.pdf

SUMMARY

We show that information pamphlets,
Web sites, leaflets distributed to doctors by the pharmaceutical
industry, and even medical journals often report
evidence in nontransparent forms that suggest big benefits
of featured interventions and small harms. Without understanding
the numbers involved, the public is susceptible
to political and commercial manipulation of their anxieties
and hopes, which undermines the goals of informed consent
and shared decision making.

Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material -Cochrane

http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004563/frame.html

"Two studies, which compared using consumer interviewers with staff interviewers as data collectors for patient satisfaction surveys, found small differences in satisfaction survey results, with less favourable results obtained when consumers were the interviewers."

Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer - Cochrane Review

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005344/frame.html

The Canadian Press: Surgeons aren't following all guidelines to lower infection risks: survey

http://www.google.com/hostednews/canadianpress/article/ALeqM5g0WNRYszHEFxjZugztFqtiNXi-wg"

Fighting cancer with the internet and social networking : The Lancet Oncology

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(08)70275-4/fulltext

Very rapidly, social networking applications, such as Wikipedia, FaceBook, YouTube, and MySpace, have risen to be in the top-ten most-used sites on the Web, reshaping how we communicate, learn, and live.

Note: there was no specific mention of one of the original online cancer sites: Association of Online Cancer Resources:
http://www.acor.org