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Genetic counselling and testing of susceptibility genes for therapeutic decision-making in breast cancer—an European consensus statement and expert recommendations

Singer, Christian F.; Balmaña, Judith; Bürki, Nicole; Delaloge, Suzette; Filieri, Maria Elisabetta; Gerdes, Anna Marie; Grindedal, Eli Marie; Han, Sileni; Johansson, Oskar and Kaufman, Bella, et al. (2019) In European Journal of Cancer 106. p.54-60
Abstract

An international panel of experts representing 17 European countries and Israel convened to discuss current needs and future developments in BRCA testing and counselling and to issue consensus recommendations. The experts agreed that, with the increasing availability of high-throughput testing platforms and the registration of poly-ADP-ribose-polymerase inhibitors, the need for genetic counselling and testing will rapidly increase in the near future. Consequently, the already existing shortage of genetic counsellors is expected to worsen and to compromise the quality of care particularly in individuals and families with suspected or proven hereditary breast or ovarian cancer. Increasing educational efforts within the breast cancer... (More)

An international panel of experts representing 17 European countries and Israel convened to discuss current needs and future developments in BRCA testing and counselling and to issue consensus recommendations. The experts agreed that, with the increasing availability of high-throughput testing platforms and the registration of poly-ADP-ribose-polymerase inhibitors, the need for genetic counselling and testing will rapidly increase in the near future. Consequently, the already existing shortage of genetic counsellors is expected to worsen and to compromise the quality of care particularly in individuals and families with suspected or proven hereditary breast or ovarian cancer. Increasing educational efforts within the breast cancer caregiver community may alleviate this limitation by enabling all involved specialities to perform genetic counselling. In the therapeutic setting, for patients with a clinical suspicion of genetic susceptibility and if the results may have an immediate impact on the therapeutic strategy, the majority voted that BRCA1/2 testing should be performed after histological diagnosis of breast cancer, regardless of oestrogen receptor and human epidermal growth factor receptor 2 (HER2) status. Experts also agreed that, in the predictive and therapeutic setting, genetic testing should be limited to individuals with a personal or family history suggestive of a BRCA1/2 pathogenic variant and should also include high-risk actionable genes beyond BRCA1/2. Of high-risk actionable genes, all pathological variants (i.e. class IV and V) should be reported; class III variants of unknown significance, should be reported provided that the current lack of clinical utility of the variant is expressly stated. Genetic counselling should always address the possibility that already tested individuals might be re-contacted in case new information on a particular variant results in a re-classification.

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published
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keywords
BRCA, BRCA1, BRCA2, Genetic counselling, Genetic testing, Hereditary breast cancer, Metastatic breast cancer
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European Journal of Cancer
volume
106
pages
7 pages
publisher
IFAC & Elsevier Ltd.
external identifiers
  • scopus:85056856124
ISSN
0959-8049
DOI
10.1016/j.ejca.2018.10.007
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English
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yes
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de1ade39-886e-48a1-9a03-31f2f9e6dc23
date added to LUP
2018-11-29 12:11:12
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2019-01-06 14:17:51
@article{de1ade39-886e-48a1-9a03-31f2f9e6dc23,
  abstract     = {<p>An international panel of experts representing 17 European countries and Israel convened to discuss current needs and future developments in BRCA testing and counselling and to issue consensus recommendations. The experts agreed that, with the increasing availability of high-throughput testing platforms and the registration of poly-ADP-ribose-polymerase inhibitors, the need for genetic counselling and testing will rapidly increase in the near future. Consequently, the already existing shortage of genetic counsellors is expected to worsen and to compromise the quality of care particularly in individuals and families with suspected or proven hereditary breast or ovarian cancer. Increasing educational efforts within the breast cancer caregiver community may alleviate this limitation by enabling all involved specialities to perform genetic counselling. In the therapeutic setting, for patients with a clinical suspicion of genetic susceptibility and if the results may have an immediate impact on the therapeutic strategy, the majority voted that BRCA1/2 testing should be performed after histological diagnosis of breast cancer, regardless of oestrogen receptor and human epidermal growth factor receptor 2 (HER2) status. Experts also agreed that, in the predictive and therapeutic setting, genetic testing should be limited to individuals with a personal or family history suggestive of a BRCA1/2 pathogenic variant and should also include high-risk actionable genes beyond BRCA1/2. Of high-risk actionable genes, all pathological variants (i.e. class IV and V) should be reported; class III variants of unknown significance, should be reported provided that the current lack of clinical utility of the variant is expressly stated. Genetic counselling should always address the possibility that already tested individuals might be re-contacted in case new information on a particular variant results in a re-classification.</p>},
  author       = {Singer, Christian F. and Balmaña, Judith and Bürki, Nicole and Delaloge, Suzette and Filieri, Maria Elisabetta and Gerdes, Anna Marie and Grindedal, Eli Marie and Han, Sileni and Johansson, Oskar and Kaufman, Bella and Krajc, Mateja and Loman, Niklas and Olah, Edith and Paluch-Shimon, Shani and Plavetic, Natalija Dedic and Pohlodek, Kamil and Rhiem, Kerstin and Teixeira, Manuel and Evans, D. Gareth},
  issn         = {0959-8049},
  keyword      = {BRCA,BRCA1,BRCA2,Genetic counselling,Genetic testing,Hereditary breast cancer,Metastatic breast cancer},
  language     = {eng},
  pages        = {54--60},
  publisher    = {IFAC & Elsevier Ltd.},
  series       = {European Journal of Cancer},
  title        = {Genetic counselling and testing of susceptibility genes for therapeutic decision-making in breast cancer—an European consensus statement and expert recommendations},
  url          = {http://dx.doi.org/10.1016/j.ejca.2018.10.007},
  volume       = {106},
  year         = {2019},
}