Ontario family history assessment tool

They can be used to guide referrals to genetic counseling for more definitive risk assessment. Onset age, y. Any age. Did any woman in your family have breast and ovarian cancer? Personal history: current age, age at menopause, age at menarche, child-birth history, menopausal status, use of menopausal hormone therapy.

Personal breast history, breast density optional , prior breast biopsy, history of cancer breast or ovarian , genetic testing. Family history genetic risk —relatives with breast or ovarian cancer, age at diagnosis, genetic testing. These include breast cancer diagnosis before age 50 years, bilateral breast cancer, presence of both breast and ovarian cancer in one individual, male family members with breast cancer, multiple cases of breast cancer in the family, 1 or more family members with 2 primary types of BRCA -related cancer such as ovarian cancer , and Ashkenazi Jewish ancestry.

The USPSTF recognizes that each risk assessment tool has advantages and limitations and found insufficient evidence to recommend one over another. Several professional organizations describe the skills and training necessary to provide comprehensive genetic counseling.

The type of mutation analysis required depends on family history. Individuals from families with known mutations or from ancestry groups in which certain mutations are more common e. The availability of testing options has changed since the U. The National Cancer Institute Cancer Genetics Services Directory provides a list of professionals who offer services related to cancer genetics, including cancer risk assessment, genetic counseling, and genetic testing.

This recommendation statement was first published in JAMA. Department of Health and Human Services, or the U. Public Health Service. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Medicine Baltimore. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Wooster R, Weber BL.

Breast and ovarian cancer. N Engl J Med. Pathologic findings at risk-reducing salpingo-oophorectomy: primary results from Gynecologic Oncology Group trial GOG J Clin Oncol. American Cancer Society. Accessed July 3, Risk models for familial ovarian and breast cancer. Genet Epidemiol. Anglian Breast Cancer Study Group. Br J Cancer. Cultur Divers Ethnic Minor Psychol. The evolution of worry after breast cancer risk assessment: 6-year follow-up of the TRACE study cohort.

Development of a risk assessment tool for women with a family history of breast cancer. Cancer Detect Prev. A randomised controlled trial of breast cancer genetics services in South East Scotland: psychological impact. Arch Intern Med. Results of a randomized study of telephone versus in-person breast cancer risk counseling.

A randomised comparison of UK genetic risk counselling services for familial cancer: psychosocial outcomes. Healthy women with a family history of breast cancer: impact of a tailored genetic counseling intervention on risk perception, knowledge, and menopausal therapy decision making. J Womens Health Larchmt. Risk perception among women receiving genetic counseling: a population-based follow-up study. Psychosocial consequences of genetic counseling: a population-based follow-up study.

Breast J. Longer-term influence of breast cancer genetic counseling on cognitions and distress: smaller benefits for affected versus unaffected women. Does enhanced information at cancer genetic counseling improve counselees' knowledge, risk perception, satisfaction and negotiation of information to at-risk relatives? A randomized study. Acta Oncol. A systematic review of the impact of genetic counseling on risk perception accuracy. A randomized trial of specialist genetic assessment: psychological impact on women at different levels of familial breast cancer risk.

Psychological support needs for women at high genetic risk of breast cancer: some preliminary indicators. A randomized trial of breast cancer risk counseling: interacting effects of counseling, educational level, and coping style. Health Psychol. Communication and information-giving in high-risk breast cancer consultations: influence on patient outcomes.

The impact of genetic counselling on risk perception and mental health in women with a family history of breast cancer. Family history of breast cancer: what do women understand and recall about their genetic risk? Impact of a primary care based intervention on breast cancer knowledge, risk perception and concern: a randomized, controlled trial. Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Eur J Hum Genet.

Impact of panel gene testing for hereditary breast and ovarian cancer on patients. Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial.

Tamoxifen for the prevention of breast cancer: late results of the Italian randomized tamoxifen prevention trial among women with hysterectomy. Long-term results of tamoxifen prophylaxis for breast cancer—month follow-up of the randomized IBIS-I trial. Effect of raloxifene on the incidence of invasive breast cancer in postmenopausal women with osteoporosis categorized by breast cancer risk.

Clin Cancer Res. Reduced incidence of invasive breast cancer with raloxifene among women at increased coronary risk. Anastrozole for prevention of breast cancer in high-risk postmenopausal women IBIS-II : an international, double-blind, randomised placebo-controlled trial.

Exemestane for breast-cancer prevention in postmenopausal women. Changes in bone mineral density at 3 years in postmenopausal women receiving anastrozole and risedronate in the IBIS-II bone substudy: an international, double-blind, randomised, placebo-controlled trial [published correction appears in Lancet Oncol. Lancet Oncol. Quality of life in MAP. Cancer Prev Res. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer.

New Engl J Med. Risk reducing mastectomy: outcomes in 10 European centres. Breast cancer after bilateral risk-reducing mastectomy. Substantial breast cancer risk reduction and potential survival benefit after bilateral mastectomy when compared with surveillance in healthy BRCA1 and BRCA2 mutation carriers: a prospective analysis.

Ann Oncol. Surgical decision making in the BRCA-positive population: institutional experience and comparison with recent literature. Prophylactic oophorectomy reduces breast cancer penetrance during prospective, long-term follow-up of BRCA1 mutation carriers.

Bilateral oophorectomy and breast cancer risk reduction among women with a family history. J Natl Cancer Inst Monogr. Familial context of genetic testing for cancer susceptibility: moderating effect of siblings' test results on psychological distress one to two weeks after BRCA1 mutation testing. Dagan E, Shochat T. Clinical characteristics affect the impact of an uninformative DNA test result: the course of worry and distress experienced by women who apply for genetic testing for breast cancer.

Psychological impact of genetic testing in women from high-risk breast cancer families. Eur J Cancer. Psychological impact of genetic testing for breast cancer susceptibility in women of Ashkenazi Jewish background: a prospective study. Genet Test. Ann Behav Med. Identification of patients at high risk of psychological distress after BRCA1 genetic testing.

Genet Test Mol Biomarkers. BRCA1 testing with definitive results: a prospective study of psychological distress in a large clinic-based sample. The relationship between coping strategies and anxiety in women from families with familial breast-ovarian cancer in the absence of demonstrated mutations. Effectiveness of alternating mammography and magnetic resonance imaging for screening women with deleterious BRCA mutations at high risk of breast cancer.

Differences between first and subsequent rounds of the MRISC breast cancer screening program for women with a familial or genetic predisposition. Lifetime risk for breast cancer doubles with a score of more than ten. A patient is required to complete the checklist only if she has any family history of breast or ovarian cancer. Patient is positive for screening and is referred for genetic counseling if 2 or more items in the above list are checked.

Score is given for every family member including second or third degree relative with a history of breast or ovarian cancer. Referral to genetic counseling is done with a score equal to or more than 8. Following questions should be asked in order to screen patients for presence of potentially harmful BRCA mutations:.

Refer to genetic counseling with one or more positive response. Ontario Ancestors is honoured to provide free webhosting to this important and independent Canadian genealogical resource. Read more ». This Web