Recognizing BRCA gene mutation risk subsequent to breast cancer diagnosis in southwestern Ontario

Meredith Vanstone; Winsion Chow; Laura Lester; Peter Ainsworth; Jeff Nisker; Muriel Brackstone

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Figure 1
Chart review process
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Figure 2
Source of patient referral to genetic counseling

OFBCR—Ontario Familial Breast Cancer Registry.

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Table 1

Number of women who were eligible (according to Ontario Ministry of Health criteria) for BRCA testing before being diagnosed with breast cancer, based on family history

GROUPS	FAMILY HISTORY TESTING CRITERIA^*	NO. OF PATIENTS WHO WOULD HAVE QUALIFIED FOR TESTING BEFORE DIAGNOSIS (TOTAL = 41)	POSITIVITY RATE IN LRCP DATABASE, FOR ALL TESTED PROBANDS, 1997–2008^† (N = 1270), %
Group 1	Ashkenazi Jewish AND breast cancer at age < 50 y OR ovarian cancer at any age	0	0.0
Group 2	Breast cancer at age < 35 y	4	7.7
Group 3	Male breast cancer at any age	0	0.0
Group 4	Invasive serous ovarian cancer at any age	0	8.5
Group 5	Breast cancer at age < 60 y AND first- or second-degree relative with ovarian cancer OR male breast cancer at any age	4	13.3
Group 6	Breast and ovarian cancer in same individual OR bilateral breast cancer with first case at age < 50 y	9	15.4
Group 7	Two cases of breast cancer in first- or second-degree relatives at age < 50 y	4	15.1
Group 8	Two cases of ovarian cancer, at any age, in first- or second-degree relatives	0	15.8
Group 9	Ashkenazi Jewish with breast cancer at any age and family history of breast or ovarian cancer	0	11.8
Group 10	Three or more cases of breast or ovarian cancer	24	12.3

LRCP—London Regional Cancer Program.
↵* Data from the Predictive Cancer Genetics Steering Committee, 2001.²⁸
↵† Positivity rate data are LRCP internal data for probands tested between 1997 and 2008. A proband is an individual being studied or reported on. A proband is usually the first affected individual in a family who brings a genetic disorder to the attention of the medical community.³⁵