Special Issue "BRCA Mutations and Cancer"
A special issue of Cancers (ISSN 2072-6694).
Deadline for manuscript submissions: closed (30 September 2018).
Genetic testing for susceptibility for breast cancer has come a long way since 1995. In this Special Issue of Cancers, we explore several topics related to the contemporary management of women with a mutation in a cancer susceptibility gene. We started out with two genes (BRCA1 and BRCA2) and have now arrived at panels of twenty or more genes in the test set. It is important that we keep generating information and knowledge of how to best use the results of the panoply of genes in the patients’ interest. This involves differentiating between benign variants and cancer-causing mutations and understanding the range of cancers and the inherent risks associated with each of these genes. Depending on the expected likelihood of developing a cancer, a woman may choose between intensified screening or preventive surgery. We would like to increase the options to include chemoprevention as well, as long as the drug is safe and tolerable and the evidence is solid.
It is also important that our recommendations reflect the state of a woman’s life. Some women may get a positive result with no history of cancer. Others will have a recent or past history of cancer. In the era of personalized medicine, it is thought that we can best manage new cancer with individualized care, which may mean a change in drug therapy and more expensive surgery. It is not clear how we apply these principles to women who have been treated for cancer in the past—say for ten-year survivors. We are also expanding the range of women tested. With next generation sequencing, the costs are no long prohibitive and we wonder if it is time to offer genetic testing to all women who wish to have it. This calls for new models of counselling and care. In addition, for women with a positive mutations, but no family history, does this change the management plans? Some have suggested that we can use data about other genes in the form of single nucleotide polymorphisms to help us refine risk and guide management decisions. In this issue of Cancers we have a panels of experts weigh in on these important issues in this evolving field.
Dr. Steven Narod
Manuscript Submission Information
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