What Your Genes Can Tell You
If you have ever wondered about your risk of developing breast cancer or other cancers because of your family history, you may want to learn more about genetic counseling. Genetic counseling can provide an assessment of your personal risk for developing breast and other related cancers as well as an individualized plan for follow up and preventative care. The University of Michigan Comprehensive Cancer Center’s Breast & Ovarian Cancer Risk Evaluation Program provides that information in addition to education regarding the availability of genetic testing.
Kara Milliron, a board certified genetic counselor at the Breast and Ovarian Cancer Risk Evaluation Program at the University of Michigan Comprehensive Cancer Center, coordinates the clinic and provides genetic counseling for patients. Milliron says, "The role of a genetic counselor is that of a patient advocate and educator. Even before a high-risk patient makes any decisions regarding [genetic] testing, Dr. Merajver [the program's director] and I will review the family history and try to determine what the potential risks are to that individual for either having the genetic condition and/or passing it on to future generations." A counseling session typically takes two hours. Counselors discuss the risks, benefits and limitations to genetic testing.
When Is the Right Time?
After hearing the risks and benefits of genetic testing some patients decline genetic testing to determine if they have the genes (most commonly BRCA 1 and/or 2, but other genes do exist) associated with breast and ovarian cancer. Some patients don't want to know that they are at such great risk and others are concerned about possible discrimination for life or disability insurance because of their high-risk status. Milliron adds, “We are respectful of their right not to know.”
Milliron points out that “how a patient feels today, might not be the way he or she feels tomorrow” about genetic testing. She says a patient’s thoughts and feelings change over time. Milliron stresses that patients are welcome to seek more information and/or genetic counseling whenever they are ready.
Advances
In her thirteen years with the program, Milliron has witnessed a number of advances. Patients are seeking answers earlier, there are more interventions to prevent cancer and improved screening (magnetic resonance imaging, more commonly known as MRI) can help detect breast cancers in high-risk women at a much earlier stage than other methods of screening. Milliron says, "We are making advances at decreasing morbidity and mortality in high-risk patients."
A Patient’s Choice
Milliron says that “one of the biggest barriers to genetic counseling” is that people are afraid they will be told what they should do. She says, “Genetic counseling is non-directive. We don’t tell patients what to do.” Genetic counselors provide the information so that patients can make informed decisions.
For more information about the University of Michigan Breast and Ovarian Cancer Risk Evaluation Program, call: 800-865-1125 or 734-764-0107 or visit Breast & Ovarian Cancer Genetic Risks.
