How common are breast and prostate cancer?
Due to changes in lifestyles, breast cancer in women has become more common over the past one hundred years and now 1 in 8 women in the UK are affected. Prostate cancer also affects 1 in 8 men and we know that inherited factors, such as mutations in the BRCA1 and BRCA2 genes, can significantly increase the risks of both of these types of tumours.
With early detection 90% of patients diagnosed with breast and prostate cancer can be long term survivors.
How commonly are they inherited?
The occurrence of BRCA1 or BRCA2 gene mutations in breast cancer
- 1/300 women in the general population
- 1/50 women of Ashkenazi Jewish ethnicity
Inherited BRCA1 and BRCA2 mutations are identified in approximately 2% of all breast cancer patients, and approximately 15% of ovarian cancer cases (High Grade Serous). However, BRCA doesn’t just affect women; men with a BRCA2 mutation have a 25% lifetime risk of developing prostate cancer. Whilst 1% of prostate cancer patients will have a BRCA mutation, this likelihood is higher if there is a family history of breast and/or prostate cancer
Having a family history of breast and/or prostate cancer could increase the risk of either cancer for relatives even if a genetic mutation is not identified.
How do you know if a tumour is inherited?
A tumour can be determined as inherited by taking a family history and offering genetic testing. In some situations genomic testing of blood and tumour may be possible through the 100,000 Genome Project. Results will then be confirmed in a NHS laboratory. www.genomicsengland.co.uk
Why would knowing about familial risk be helpful?
Assessing the family history of breast, ovarian and prostate cancer and then offering affected relatives genetic testing through blood tests is important in calculating risk for relatives, offering lifestyle advice, and planning screening or preventative surgery for at risk family members.
How can I identify familial risk?
Familial cancer susceptibility can be assessed using National Institute of Clinical Excellence (NICE) guidelines but these can be complex and time-consuming in primary care for general practitioners.
What is CancerPDX?
CancerPDX is a ‘digital triage’ tool to assess familial cancer risk and triage the patient in 90 seconds. CancerPDX is designed to assess familial cancer risk in individuals who do not currently have a diagnosis of breast, ovarian or prostate cancer. Furthermore, for individuals with a breast or ovarian cancer diagnosis, CancerPDX could help identify families where a BRCA1 or BRCA2 mutation may be present.
- Accurate risk assessment with minimal time and effort
- Recommendation for referral to Cancer Genetics or Secondary Care if appropriate
- Patients empowered to make an informed decision about the options available to them
Has CancerPDX been tested?
Management guidelines provided in BreastPDX and ProstatePDX are provided by the clinical genetics service of University Hospitals Leicestershire (UHL).