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Tuesday, May 14, 2013

Are There Tests Beyond BRCA Screening? Some

Breast Tests You May Have Never Had:
Is breast cancer inevitable? Is breast cancer preventable? We have talked about the simple strategies such as breast feeding, eating low fat diet, avoiding alcohol and cigarettes, and exercising.
It seems that no matter how diligent we are, breast cancer may be inevitable, for now, 1/8 American women will have it before death. The best tests to determine if you are going to be that 1/8 are the genetic tests of the Gail Scale or the Claus Model. These scales can give you a prediction of whether you are at high risk or not. These two different genetic tests work differently depending upon your family history. You can catch up on statics by checking out the Am. Cancer Society’s Fact page:
http://www.cancer.org/docroot/CRI/CRI_2x.asp?sitearea=LRN&dt=5
 other cancer facts may be at Oncolog stat
And there is blood testing for BRCA 1/2 and now there is the PALB2 gene test that is positive in some women with breast cancer in their families. 
Right now we think that breast cancer is preventable in some cases: taking tamoxifen if you are at risk, or having breast removal, both work, but neither strategy is used very often. For the most part we actually 'prevent' breast cancer consequences more than preventing it altogether, as we are typically finding out about early disease and then treating the early disease. It's most important to follow mammogram guidelines and clinical breast exams with your gyno, but after that there may be other tests that would be useful. I highly recommend our patients with risk factors actually get the last test first, a Gail Scale analysis. I also recommend the Halo breast pap. For those with breast symptoms the ultrasound test is important. And you do not necessarily need a genetic counselor to get the breast cancer gene test, it is done by blood draw and the results come with a very clear pamphlet on what they may mean. However, it is important that you have a physician whom feels comfortable speaking about the genetic tests results with you. So here's a list so that you know there are tests out there beyond mammograms, which are most valuable, before you take any action such as breast removal.

1. Breast Ultrasound
2. Gail Scale Scoring, or scoring by the Claus Model to determine your own risk
3. BRCA 1/2 Gene Testing4. CellSearch ® Circulating Tumor Cell (CTC) Test from Veridex
5. MammaPrint(R)
6. The HALO™ Breast Pap Test
7. PreOvar (more specific for ovarian cancers)
8. Needle localization biopsy of an abnormal mass
9. Yearly breast exam by your gyno
10. PALB2 gene testing
11. 3D mammography
And which ones are right for you? Keep reading!

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