Skip to main content
Top
Published in: Familial Cancer 2/2011

01-06-2011

Genetic counseling for patients and families with hereditary breast and ovarian cancer in a developing Asian country: an observational descriptive study

Authors: Sook-Yee Yoon, Meow-Keong Thong, Nur Aishah Mohd Taib, Cheng-Har Yip, Soo-Hwang Teo

Published in: Familial Cancer | Issue 2/2011

Login to get access

Abstract

Genetic counseling (GC) and genetic testing are vital risk management strategies in hereditary breast and ovarian cancer (HBOC) syndromes. Hitherto, cancer genetic testing amongst Asians has been described only in developed and high-income Asian countries. We studied the uptake and acceptance of GC and genetic testing services to Asian BRCA carriers in a middle-income country. A total of 363 patients were tested by full sequencing and large rearrangement analysis of both BRCA1 and BRCA2 genes in the Malaysian Breast Cancer (MyBrCa) Genetic Study. Of these, 49 index patients (13.5%) were found to carry deleterious mutations. GC pre- and post- result disclosures were provided and these groups of patients and their families were studied. GC and genetic testing were accepted by 82% of Malaysian patients at high risk for HBOC syndromes. However, risk assessment was limited by large, geographically dispersed, often polygamous or polyandrous families, and the lack of complete cancer registry. Cultural taboos about cancer diagnoses, social marginalization and lack of regulatory control of genetic discrimination were significant concerns. Only 78% of index patients informed their families of their risks and 11% of relatives came forward when offered free counseling and testing. Even when GC and genetic testing are provided at no cost, there remain significant societal and regulatory barriers to effective cancer genetic services in this underserved Asian population. Families believe there is a need for regulatory protection against genetic discrimination. Further studies are needed in the area of increasing awareness about the potential benefits of GC and genetic testing in Asians.
Literature
1.
go back to reference Parkin DM (2000) Global cancer statistics in the year 2000. Lancet Oncol 2(9):533–543CrossRef Parkin DM (2000) Global cancer statistics in the year 2000. Lancet Oncol 2(9):533–543CrossRef
2.
go back to reference Huo D, Olopade OI (2007) Genetic testing in diverse populations: are researchers doing enough to get out the correct message? JAMA 298(24):2910–2911PubMedCrossRef Huo D, Olopade OI (2007) Genetic testing in diverse populations: are researchers doing enough to get out the correct message? JAMA 298(24):2910–2911PubMedCrossRef
3.
go back to reference Simon MS, Petrucelli N (2009) Hereditary breast and ovarian cancer syndrome: the impact of race on uptake of genetic counseling and testing. Methods Mol Biol 471:487–500PubMedCrossRef Simon MS, Petrucelli N (2009) Hereditary breast and ovarian cancer syndrome: the impact of race on uptake of genetic counseling and testing. Methods Mol Biol 471:487–500PubMedCrossRef
4.
go back to reference Palmero EI, Ashton-Prolla P, da Rocha JC et al (2007) Clinical characterization and risk profile of individuals seeking genetic counseling for hereditary breast cancer in Brazil. J Genet Couns 16(3):363–371PubMedCrossRef Palmero EI, Ashton-Prolla P, da Rocha JC et al (2007) Clinical characterization and risk profile of individuals seeking genetic counseling for hereditary breast cancer in Brazil. J Genet Couns 16(3):363–371PubMedCrossRef
5.
go back to reference Barlow-Stewart K, Yeo SS, Meiser B et al (2006) Toward cultural competence in cancer genetic counseling and genetics education: lessons learned from Chinese-Australians. Genet Med 8(1):24–32PubMedCrossRef Barlow-Stewart K, Yeo SS, Meiser B et al (2006) Toward cultural competence in cancer genetic counseling and genetics education: lessons learned from Chinese-Australians. Genet Med 8(1):24–32PubMedCrossRef
6.
go back to reference Armstrong K, Micco E, Carney A et al (2005) Racial differences in the use of BRCA1/2 testing among women with a family history of breast or ovarian cancer. JAMA 293(14):1729–1736PubMedCrossRef Armstrong K, Micco E, Carney A et al (2005) Racial differences in the use of BRCA1/2 testing among women with a family history of breast or ovarian cancer. JAMA 293(14):1729–1736PubMedCrossRef
7.
go back to reference Halbert CH, Kessler L, Stopfer JE et al (2006) Low rates of acceptance of BRCA1 and BRCA2 test results among African American women at increased risk for hereditary breast-ovarian cancer. Genet Med 8(9):576–582PubMedCrossRef Halbert CH, Kessler L, Stopfer JE et al (2006) Low rates of acceptance of BRCA1 and BRCA2 test results among African American women at increased risk for hereditary breast-ovarian cancer. Genet Med 8(9):576–582PubMedCrossRef
8.
go back to reference Hall MJ, Reid JE, Burbidge LA et al (2009) BRCA1 and BRCA2 mutations in women of different ethnicities undergoing testing for hereditary breast-ovarian cancer. Cancer 115(10):2222–2233PubMedCrossRef Hall MJ, Reid JE, Burbidge LA et al (2009) BRCA1 and BRCA2 mutations in women of different ethnicities undergoing testing for hereditary breast-ovarian cancer. Cancer 115(10):2222–2233PubMedCrossRef
9.
go back to reference Lagos VI, Perez MA, Ricker CN et al (2008) Social-cognitive aspects of underserved Latinas preparing to undergo genetic cancer risk assessment for hereditary breast and ovarian cancer. Psycho-oncology 17(8):774–782PubMedCrossRef Lagos VI, Perez MA, Ricker CN et al (2008) Social-cognitive aspects of underserved Latinas preparing to undergo genetic cancer risk assessment for hereditary breast and ovarian cancer. Psycho-oncology 17(8):774–782PubMedCrossRef
10.
go back to reference Susswein LR, Skrzynia C, Lange LA et al (2008) Increased uptake of BRCA1/2 genetic testing among African American women with a recent diagnosis of breast cancer. J Clin Oncol 26(1):32–36PubMedCrossRef Susswein LR, Skrzynia C, Lange LA et al (2008) Increased uptake of BRCA1/2 genetic testing among African American women with a recent diagnosis of breast cancer. J Clin Oncol 26(1):32–36PubMedCrossRef
11.
go back to reference Chin TM, Tan SH, Lim SE et al (2005) Acceptance, motivators, and barriers in attending breast cancer genetic counseling in Asians. Cancer Detect Prev 29(5):412–418PubMedCrossRef Chin TM, Tan SH, Lim SE et al (2005) Acceptance, motivators, and barriers in attending breast cancer genetic counseling in Asians. Cancer Detect Prev 29(5):412–418PubMedCrossRef
12.
go back to reference Zhang WJ, Gao YJ, Li QB et al (2006) Breast cancer in China: demand for genetic counseling and genetic testing. Genet Med 8(3):196–197PubMedCrossRef Zhang WJ, Gao YJ, Li QB et al (2006) Breast cancer in China: demand for genetic counseling and genetic testing. Genet Med 8(3):196–197PubMedCrossRef
13.
go back to reference Thirthagiri E, Lee SY, Kang P et al (2008) Evaluation of BRCA1 and BRCA2 mutations and risk-prediction models in a typical Asian country (Malaysia) with a relatively low incidence of breast cancer. Breast Cancer Res 10(4):R59PubMedCrossRef Thirthagiri E, Lee SY, Kang P et al (2008) Evaluation of BRCA1 and BRCA2 mutations and risk-prediction models in a typical Asian country (Malaysia) with a relatively low incidence of breast cancer. Breast Cancer Res 10(4):R59PubMedCrossRef
14.
go back to reference Toh GT, Kang P, Lee SS et al (2008) BRCA1 and BRCA2 germline mutations in Malaysian women with early-onset breast cancer without a family history. PLoS One 3(4):e2024PubMedCrossRef Toh GT, Kang P, Lee SS et al (2008) BRCA1 and BRCA2 germline mutations in Malaysian women with early-onset breast cancer without a family history. PLoS One 3(4):e2024PubMedCrossRef
15.
go back to reference Kang P, Mariapun S, Phuah SY et al (2010) Large BRCA1 and BRCA2 genomic rearrangements in Malaysian high risk breast-ovarian cancer families. Breast Cancer Res Treat. doi:10.1007/s10549-010-1018-521 Kang P, Mariapun S, Phuah SY et al (2010) Large BRCA1 and BRCA2 genomic rearrangements in Malaysian high risk breast-ovarian cancer families. Breast Cancer Res Treat. doi:10.​1007/​s10549-010-1018-521
16.
go back to reference Purnomosari D, Pals G, Wahyono A et al (2007) BRCA1 and BRCA2 germline mutation analysis in the Indonesian population. Breast Cancer Res Treat 106(2):297–304PubMedCrossRef Purnomosari D, Pals G, Wahyono A et al (2007) BRCA1 and BRCA2 germline mutation analysis in the Indonesian population. Breast Cancer Res Treat 106(2):297–304PubMedCrossRef
17.
go back to reference Tang NL, Choy KW, Pang CP et al (2001) Prevalence of breast cancer predisposition gene mutations in Chinese women and guidelines for genetic testing. Clin Chim Acta 313(1–2):179–185PubMedCrossRef Tang NL, Choy KW, Pang CP et al (2001) Prevalence of breast cancer predisposition gene mutations in Chinese women and guidelines for genetic testing. Clin Chim Acta 313(1–2):179–185PubMedCrossRef
18.
go back to reference Hedau S, Jain N, Husain SA et al (2004) Novel germline mutations in breast cancer susceptibility genes BRCA1, BRCA2 and p53 gene in breast cancer patients from India. Breast Cancer Res Treat 88(2):177–186PubMedCrossRef Hedau S, Jain N, Husain SA et al (2004) Novel germline mutations in breast cancer susceptibility genes BRCA1, BRCA2 and p53 gene in breast cancer patients from India. Breast Cancer Res Treat 88(2):177–186PubMedCrossRef
19.
go back to reference The General Report of the Population and Housing Census (2000) Department of Statistics, Malaysia The General Report of the Population and Housing Census (2000) Department of Statistics, Malaysia
20.
go back to reference Lim GCC, Yahaya H (2008) Third report of the national cancer registry: cancer incidence in Malaysia (2003–2005): ministry of health, Malaysia Lim GCC, Yahaya H (2008) Third report of the national cancer registry: cancer incidence in Malaysia (2003–2005): ministry of health, Malaysia
21.
go back to reference Heshka JT, Palleschi C, Howley H et al (2008) A systematic review of perceived risks, psychological and behavioral impacts of genetic testing. Genet Med 10(1):19–32PubMedCrossRef Heshka JT, Palleschi C, Howley H et al (2008) A systematic review of perceived risks, psychological and behavioral impacts of genetic testing. Genet Med 10(1):19–32PubMedCrossRef
22.
go back to reference Meiser B, Gaff C, Julian-Reynier C et al (2006) International perspectives on genetic counseling and testing for breast cancer risk. Breast Dis 27:109–125PubMed Meiser B, Gaff C, Julian-Reynier C et al (2006) International perspectives on genetic counseling and testing for breast cancer risk. Breast Dis 27:109–125PubMed
23.
go back to reference Vadaparampil ST, Ropka M, Stefanek ME (2005) Measurement of psychological factors associated with genetic testing for hereditary breast, ovarian and colon cancers. Fam Cancer 4(2):195–206PubMedCrossRef Vadaparampil ST, Ropka M, Stefanek ME (2005) Measurement of psychological factors associated with genetic testing for hereditary breast, ovarian and colon cancers. Fam Cancer 4(2):195–206PubMedCrossRef
24.
go back to reference Keogh LA, Southey MC, Maskiell J et al (2004) Uptake of offer to receive genetic information about BRCA1 and BRCA2 mutations in an Australian population-based study. Cancer Epidemiol Biomarkers Prev 13(12):2258–2263PubMed Keogh LA, Southey MC, Maskiell J et al (2004) Uptake of offer to receive genetic information about BRCA1 and BRCA2 mutations in an Australian population-based study. Cancer Epidemiol Biomarkers Prev 13(12):2258–2263PubMed
25.
go back to reference Finlay E, Stopfer JE, Burlingame E et al (2008) Factors determining dissemination of results and uptake of genetic testing in families with known BRCA1/2 mutations. Genet Test 12(1):81–91PubMedCrossRef Finlay E, Stopfer JE, Burlingame E et al (2008) Factors determining dissemination of results and uptake of genetic testing in families with known BRCA1/2 mutations. Genet Test 12(1):81–91PubMedCrossRef
26.
go back to reference Murff HJ, Byrne D, Haas JS et al (2005) Race and family history assessment for breast cancer. J Gen Intern Med 20(1):75–80PubMedCrossRef Murff HJ, Byrne D, Haas JS et al (2005) Race and family history assessment for breast cancer. J Gen Intern Med 20(1):75–80PubMedCrossRef
27.
go back to reference Qureshi N, Carroll JC, Wilson B et al (2009) The current state of cancer family history collection tools in primary care: a systematic review. Genet Med 11(7):495–506PubMedCrossRef Qureshi N, Carroll JC, Wilson B et al (2009) The current state of cancer family history collection tools in primary care: a systematic review. Genet Med 11(7):495–506PubMedCrossRef
28.
go back to reference Murff HJ, Spigel DR, Syngal S (2004) Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 292(12):1480–1489PubMedCrossRef Murff HJ, Spigel DR, Syngal S (2004) Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 292(12):1480–1489PubMedCrossRef
29.
go back to reference Fortuny D, Balmaña J, Graña B et al (2009) Opinion about reproductive decision making among individuals undergoing BRCA1/2 genetic testing in a multicentre Spanish cohort. Hum Reprod 24(4):1000–1006PubMedCrossRef Fortuny D, Balmaña J, Graña B et al (2009) Opinion about reproductive decision making among individuals undergoing BRCA1/2 genetic testing in a multicentre Spanish cohort. Hum Reprod 24(4):1000–1006PubMedCrossRef
30.
go back to reference Menon U, Harper J, Sharma A et al (2007) Views of BRCA gene mutation carriers on preimplantation genetic diagnosis as a reproductive option for hereditary breast and ovarian cancer. Hum Reprod 22(6):1573–1577PubMedCrossRef Menon U, Harper J, Sharma A et al (2007) Views of BRCA gene mutation carriers on preimplantation genetic diagnosis as a reproductive option for hereditary breast and ovarian cancer. Hum Reprod 22(6):1573–1577PubMedCrossRef
31.
go back to reference Douglas HA, Hamilton RJ, Grubs RE (2009) The effect of BRCA gene testing on family relationships: a thematic analysis of qualitative interviews. J Genet Couns 18(5):418–435PubMedCrossRef Douglas HA, Hamilton RJ, Grubs RE (2009) The effect of BRCA gene testing on family relationships: a thematic analysis of qualitative interviews. J Genet Couns 18(5):418–435PubMedCrossRef
Metadata
Title
Genetic counseling for patients and families with hereditary breast and ovarian cancer in a developing Asian country: an observational descriptive study
Authors
Sook-Yee Yoon
Meow-Keong Thong
Nur Aishah Mohd Taib
Cheng-Har Yip
Soo-Hwang Teo
Publication date
01-06-2011
Publisher
Springer Netherlands
Published in
Familial Cancer / Issue 2/2011
Print ISSN: 1389-9600
Electronic ISSN: 1573-7292
DOI
https://doi.org/10.1007/s10689-011-9420-7

Other articles of this Issue 2/2011

Familial Cancer 2/2011 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine