Asesoramiento genético: Breast Cancer - Ashkenazi Jew

· Breast Cancer - Ashkenazi Jew Contents 1 Introducción 2 Contratación 3 Family history 4 Medical history 5 Psychosocial 6 Causes of breast cancer 7 Who do we offer testing for - at greater risk? 8 Based on your family history 9 Familial chance of risk 10 Cancer risks (for carriers of BRCA1/2) 11 Testing 12 Discrimination Issues 13 Results 14 Administración 15 Notes Introduction How are they, did they have any problems finding the place? Contracting Find out what she knows about cancer and testing. Review family history Review medical history What cancer is, how it happens Talk about the specific risks to your family Talk about the testing options and what it can tell you. Talk about management Family history Names of relatives Cousins? Daughters' screening practices? Any more details about age of living uncles (paternal and maternal) Bilateral/unilateral cancers? Any idea about country paternal great-grandmother is from? Anyone else with cancer? Could we get documentation of the sarcoma or brain tumors? Any leukemias? Any pancreatic, melanoma? Medical history How is she doing currently? What are current screening practices? mammograms, self exams? Any surgeries? Any hospitalizations? medicamentos? Exercise/diet? Psychosocial (throughout) Recently diagnosed with cancer/ currently undergoing treatment. How are you dealing with all of this? Who do you go to for support? Many family members with cancer. How did that impact your idea of risk? Have you talked about this appointment with your family? Are you concerned for your own health, what are your concerns/fears? Have you considered the implications to the rest of your family? Have you thought about what if it wasn't familial? How will you feel if testing is not warranted? Causes of breast cancer Basic definition: the uncontrolled growth of cells. Divisions 70-80% = sporadic (just happens to people for no connected reason -no previous family history) 20-30% = familial chance alone genetic susceptibility shared environment combination 5-10% = inherited - this is what we are concerned about and can help you test for BRCA1 BRCA2 other genes? Genes and chromosomes People -> genes -> nucleotides = CAGT chromosomes = instruction manual genes= instructions amnio acids = words nucleotides = letters Two copies of every chromosome, every gene. Dominant Inheritance (50%) Cancer is actually caused by a change in a tumor supressor gen*= they control cell growt*When both copies of the gene are changed (have a mutation) they cannot stop cell growth = tumor. (Two-hit hypothesis) Two different ways it can be affected acquired inherited The genes Chromosome 17 (BRCA1) Cromosoma 13 (BRCA2) Who do we offer testing for - at greater risk? More than one family member with cancer* Single woman with breast and ovarian Woman with bilateral breast cancer Early onset age of cancer (