Editorial/Original Paper - Panel Testing Is Not a Panacea Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Monday, March 14, 2016

Editorial/Original Paper - Panel Testing Is Not a Panacea

Editorial - open access
  Public interest in genetics continues to be bolstered by media coverage, especially when endorsed by a celebrity. For example, when Angelina Jolie announced that she is a BRCA1 mutation carrier and elected to have bilateral prophylactic mastectomy, the general public was highly aware of her story, but did not have an improved understanding of the accompanying issues.14

....Consequently, although there is undoubtedly an economic and time advantage to panel genetic testing versus a step-wise approach, more testing is not necessarily better testing. Data such as those reported by Thompson et al1 clearly identify clinically relevant genes beyond BRCA1 and BRCA2, and panel testing for genes with clear phenotypic overlap is justified. For example, evidence is mounting that PALB2 may be clinically indistinguishable from BRCA2 with regard to breast cancer risk10; this is further supported by the data in the study by Thompson et al1, leading them to refer to PALB2 as an ideal panel gene. However, testing clinically for large numbers of genes with unclear clinical significance—or including genes that are not indicated on the basis of personal history, family history, or ethnicity just because we can—may be putting the cart before the horse. The issues currently being faced in clinical genetics will continue and will likely increase exponentially. As quickly as new genes are discovered, clinical laboratories will incorporate them into their panels. Alas, that proverbial horse may already be out of the barn. Therefore, particularly in this era of considerable uncertainty, complex, clinical panel-based genetic testing should be approached with extreme caution, and ideally only in consultation with trained genetics professionals.18


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