Doctors should assess BRCA risk in women with family history, panel advises

Women with a family history of breast or ovarian cancer should be assessed to see if those cancers could be linked to certain mutations, according to new recommendations.

Only if the assessments suggest a possible connection should women get genetic counseling and - if warranted - be tested for BRCA mutations, the U.S. Preventive Services Task Force (USPSTF) confirmed today.

The panel's final recommendation largely mirrors draft guidelines released earlier this year (see Reuters Health story of April 2, 2013 here:

"The first thing to understand is the vast majority of women will not need this testing and will not benefit from it," Dr. Douglas K. Owens said.

Owens is a member of the USPSTF as well as a professor at Stanford University and senior investigator at the VA Palo Alto Health Care System in California.

"We're talking about a small group of women that have a family history that suggests there may be a risk of BRCA mutations," he told Reuters Health.

One in 300 to one in 500 women has a so-called BRCA mutation - a version of a gene with small changes in it that heighten the risk of developing cancer. Depending on their specific gene changes, those women have up to a 65 percent chance of getting breast cancer by age 70 and up to a 39 percent chance of getting ovarian cancer.

Women who test positive for the mutations may take medication to reduce their risk of cancer or have their breasts and ovaries removed. They can also opt for intensive cancer screening - although how well that prevents advanced disease and death is unknown.

The recommendations are based on a new review of the current evidence on testing and counseling for BRCA mutations. Both are published in the Annals of Internal Medicine.