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Published in: Journal of Genetic Counseling 5/2015

01-10-2015 | Original Research

Personalized Medicine Through SNP Testing for Breast Cancer Risk: Clinical Implementation

Authors: Rebecca Howe, Talya Miron-Shatz, Yaniv Hanoch, Zehra B. Omer, Cristina O’Donoghue, Elissa M. Ozanne

Published in: Journal of Genetic Counseling | Issue 5/2015

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Abstract

Single nucleotide polymorphisms (SNPs) have the potential to improve personalized medicine in breast cancer care. As new SNPs are discovered, further enhancing risk classification, SNP testing may serve to complement family history and phenotypic risk factors when assessed in a clinical setting. SNP analysis is particularly relevant to high-risk women who may seek out such information to guide their decision-making around risk-reduction. However, little is known about how high-risk women may respond to SNP testing with regard to clinical decision-making. We examined high-risk women’s interest in SNP testing for breast cancer risk through an online survey of hypothetical testing scenarios. Women stated their preferences for sharing test results and selected the most likely follow-up action they would pursue in each of the test result scenarios (above average and below average risk for breast cancer). Four hundred seventy-eight women participated. Most women (89 %) did not know what a SNP was prior to the study. Once SNP testing was described, 75 % were interested in SNP testing. Participants stated an interest in lifestyle interventions for risk-reduction and wanted to discuss their testing results with their doctor or a genetic counselor. Women are interested in SNP testing and are prepared to make lifestyle changes based on testing results. Women’s preference for discussing testing results with a healthcare provider aligns with the current trend towards SNP testing in a clinical setting.
Literature
go back to reference Annas, G. J., & Elias, S. (2014). 23andMe and the FDA. The New England Journal of Medicine, 370(11), 985–988.CrossRef Annas, G. J., & Elias, S. (2014). 23andMe and the FDA. The New England Journal of Medicine, 370(11), 985–988.CrossRef
go back to reference Antoniou, A. C., Beesley, J., McGuffog, L., Sinilnikova, O. M., Healey, S., Neuhausen, S. L., & Easton, D. F. (2010). Common breast cancer susceptibility alleles and the risk of breast cancer for BRCA1 and BRCA2 mutation carriers: implications for risk prediction. Cancer Research, 70(23), 9742–9754.CrossRef Antoniou, A. C., Beesley, J., McGuffog, L., Sinilnikova, O. M., Healey, S., Neuhausen, S. L., & Easton, D. F. (2010). Common breast cancer susceptibility alleles and the risk of breast cancer for BRCA1 and BRCA2 mutation carriers: implications for risk prediction. Cancer Research, 70(23), 9742–9754.CrossRef
go back to reference Bloss, C. S., Schork, N. J., & Topol, E. J. (2011). Effect of direct-to-consumer genomewide profiling to assess disease risk. The New England Journal of Medicine, 364(6), 524–534.PubMedPubMedCentral Bloss, C. S., Schork, N. J., & Topol, E. J. (2011). Effect of direct-to-consumer genomewide profiling to assess disease risk. The New England Journal of Medicine, 364(6), 524–534.PubMedPubMedCentral
go back to reference Brentnall, A. R., Evans, D. G., & Cuzick, J. (2014). Distribution of breast cancer risk from SNPs and classical risk factors in women of routine screening age in the UK. British Journal of Cancer, 110(3), 827–828.CrossRef Brentnall, A. R., Evans, D. G., & Cuzick, J. (2014). Distribution of breast cancer risk from SNPs and classical risk factors in women of routine screening age in the UK. British Journal of Cancer, 110(3), 827–828.CrossRef
go back to reference Campa, D., Kaaks, R., Le Marchand, L., Haiman, C. A., Travis, R. C., Berg, C. D., & Canzian, F. (2011). Interactions between genetic variants and breast cancer risk factors in the breast and prostate cancer cohort consortium. Journal of the National Cancer Institute, 103(16), 1252–1263.CrossRef Campa, D., Kaaks, R., Le Marchand, L., Haiman, C. A., Travis, R. C., Berg, C. D., & Canzian, F. (2011). Interactions between genetic variants and breast cancer risk factors in the breast and prostate cancer cohort consortium. Journal of the National Cancer Institute, 103(16), 1252–1263.CrossRef
go back to reference Cyrus-David, M. S. (2010). Knowledge and accuracy of perceived personal risk in underserved women who are at increased risk of breast cancer. Journal of Cancer Education : The Official Journal of the American Association for Cancer Education, 25(4), 617–623.CrossRef Cyrus-David, M. S. (2010). Knowledge and accuracy of perceived personal risk in underserved women who are at increased risk of breast cancer. Journal of Cancer Education : The Official Journal of the American Association for Cancer Education, 25(4), 617–623.CrossRef
go back to reference Daly, M. B., Lerman, C. L., Ross, E., Schwartz, M. D., Sands, C. B., & Masny, A. (1996). Gail model breast cancer risk components are poor predictors of risk perception and screening behavior. Breast Cancer Research and Treatment, 41(1), 59–70.CrossRef Daly, M. B., Lerman, C. L., Ross, E., Schwartz, M. D., Sands, C. B., & Masny, A. (1996). Gail model breast cancer risk components are poor predictors of risk perception and screening behavior. Breast Cancer Research and Treatment, 41(1), 59–70.CrossRef
go back to reference Easton, D. F., Pooley, K. A., Dunning, A. M., Pharoah, P. D. P., Thompson, D., Ballinger, D. G., & Ponder, B. A. J. (2007). Genome-wide association study identifies novel breast cancer susceptibility loci. Nature, 447(7148), 1087–1093.CrossRef Easton, D. F., Pooley, K. A., Dunning, A. M., Pharoah, P. D. P., Thompson, D., Ballinger, D. G., & Ponder, B. A. J. (2007). Genome-wide association study identifies novel breast cancer susceptibility loci. Nature, 447(7148), 1087–1093.CrossRef
go back to reference Edwards, A. G., Naik, G., Ahmed, H., Elwyn, G. J., Pickles, T., Hood, K., & Playle, R. (2013). Personalised risk communication for informed decision making about taking screening tests. Cochrane Database of Systematic Reviews (Online), 2, CD001865. Edwards, A. G., Naik, G., Ahmed, H., Elwyn, G. J., Pickles, T., Hood, K., & Playle, R. (2013). Personalised risk communication for informed decision making about taking screening tests. Cochrane Database of Systematic Reviews (Online), 2, CD001865.
go back to reference Fagerlin, A., Zikmund-Fisher, B. J., Ubel, P. A., Jankovic, A., Derry, H. A., & Smith, D. M. (2007). Measuring numeracy without a math test: development of the Subjective Numeracy Scale. Medical Decision Making : An International Journal of the Society for Medical Decision Making, 27(5), 672–680. doi:https://doi.org/10.1177/0272989X07304449.CrossRef Fagerlin, A., Zikmund-Fisher, B. J., Ubel, P. A., Jankovic, A., Derry, H. A., & Smith, D. M. (2007). Measuring numeracy without a math test: development of the Subjective Numeracy Scale. Medical Decision Making : An International Journal of the Society for Medical Decision Making, 27(5), 672–680. doi:https://​doi.​org/​10.​1177/​0272989X07304449​.CrossRef
go back to reference Graves, K. D., Peshkin, B. N., Luta, G., Tuong, W., & Schwartz, M. D. (2011). Interest in genetic testing for modest changes in breast cancer risk: implications for SNP testing. Public Health Genomics, 14(3), 178–189.CrossRef Graves, K. D., Peshkin, B. N., Luta, G., Tuong, W., & Schwartz, M. D. (2011). Interest in genetic testing for modest changes in breast cancer risk: implications for SNP testing. Public Health Genomics, 14(3), 178–189.CrossRef
go back to reference Gray, S. W., O’Grady, C., Karp, L., Smith, D., Schwartz, J. S., Hornik, R. C., & Armstrong, K. (2009). Risk information exposure and direct-to-consumer genetic testing for BRCA mutations among women with a personal or family history of breast or ovarian cancer. Cancer Epidemiology, Biomarkers & Prevention : A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 18(4), 1303–1311.CrossRef Gray, S. W., O’Grady, C., Karp, L., Smith, D., Schwartz, J. S., Hornik, R. C., & Armstrong, K. (2009). Risk information exposure and direct-to-consumer genetic testing for BRCA mutations among women with a personal or family history of breast or ovarian cancer. Cancer Epidemiology, Biomarkers & Prevention : A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 18(4), 1303–1311.CrossRef
go back to reference Hall, T. O., Renz, A. D., Snapinn, K. W., Bowen, D. J., & Edwards, K. L. (2012). Awareness and uptake of direct-to-consumer genetic testing among cancer cases, their relatives, and controls: the Northwest Cancer Genetics Network. Genetic Testing and Molecular Biomarkers, 16(7), 744–748.CrossRef Hall, T. O., Renz, A. D., Snapinn, K. W., Bowen, D. J., & Edwards, K. L. (2012). Awareness and uptake of direct-to-consumer genetic testing among cancer cases, their relatives, and controls: the Northwest Cancer Genetics Network. Genetic Testing and Molecular Biomarkers, 16(7), 744–748.CrossRef
go back to reference Heald, B., Edelman, E., & Eng, C. (2012). Prospective comparison of family medical history with personal genome screening for risk assessment of common cancers. European Journal of Human Genetics : EJHG, 20(5), 547–551.CrossRef Heald, B., Edelman, E., & Eng, C. (2012). Prospective comparison of family medical history with personal genome screening for risk assessment of common cancers. European Journal of Human Genetics : EJHG, 20(5), 547–551.CrossRef
go back to reference Hock, K. T., Christensen, K. D., Yashar, B. M., Roberts, J. S., Gollust, S. E., & Uhlmann, W. R. (2011). Direct-to-consumer genetic testing: an assessment of genetic counselors’ knowledge and beliefs. Genetics in Medicine : Official Journal of the American College of Medical Genetics, 13(4), 325–332. doi:https://doi.org/10.1097/GIM.0b013e3182011636.CrossRef Hock, K. T., Christensen, K. D., Yashar, B. M., Roberts, J. S., Gollust, S. E., & Uhlmann, W. R. (2011). Direct-to-consumer genetic testing: an assessment of genetic counselors’ knowledge and beliefs. Genetics in Medicine : Official Journal of the American College of Medical Genetics, 13(4), 325–332. doi:https://​doi.​org/​10.​1097/​GIM.​0b013e3182011636​.CrossRef
go back to reference Ingle, J. N., Liu, M., Wickerham, D. L., Schaid, D. J., Wang, L., Mushiroda, T., & Weinshilboum, R. M. (2013). Selective Estrogen Receptor Modulators and Pharmacogenomic Variation in ZNF423 Regulation of BRCA1 Expression: Individualized Breast Cancer Prevention. Cancer Discovery, 3(7), 812–825.CrossRef Ingle, J. N., Liu, M., Wickerham, D. L., Schaid, D. J., Wang, L., Mushiroda, T., & Weinshilboum, R. M. (2013). Selective Estrogen Receptor Modulators and Pharmacogenomic Variation in ZNF423 Regulation of BRCA1 Expression: Individualized Breast Cancer Prevention. Cancer Discovery, 3(7), 812–825.CrossRef
go back to reference Kaufman, D. J., Bollinger, J. M., Dvoskin, R. L., & Scott, J. A. (2012). Risky business: risk perception and the use of medical services among customers of DTC personal genetic testing. Journal of Genetic Counseling, 21(3), 413–422.CrossRef Kaufman, D. J., Bollinger, J. M., Dvoskin, R. L., & Scott, J. A. (2012). Risky business: risk perception and the use of medical services among customers of DTC personal genetic testing. Journal of Genetic Counseling, 21(3), 413–422.CrossRef
go back to reference Mealiffe, M. E., Stokowski, R. P., Rhees, B. K., Prentice, R. L., Pettinger, M., & Hinds, D. A. (2010). Assessment of clinical validity of a breast cancer risk model combining genetic and clinical information. Journal of the National Cancer Institute, 102(21), 1618–1627.CrossRef Mealiffe, M. E., Stokowski, R. P., Rhees, B. K., Prentice, R. L., Pettinger, M., & Hinds, D. A. (2010). Assessment of clinical validity of a breast cancer risk model combining genetic and clinical information. Journal of the National Cancer Institute, 102(21), 1618–1627.CrossRef
go back to reference Michailidou, K., Hall, P., Gonzalez-Neira, A., Ghoussaini, M., Dennis, J., Milne, R. L., & Easton, D. F. (2013). Large-scale genotyping identifies 41 new loci associated with breast cancer risk. Nature Genetics, 45(4), 353–361. doi:https://doi.org/10.1038/ng.2563.CrossRef Michailidou, K., Hall, P., Gonzalez-Neira, A., Ghoussaini, M., Dennis, J., Milne, R. L., & Easton, D. F. (2013). Large-scale genotyping identifies 41 new loci associated with breast cancer risk. Nature Genetics, 45(4), 353–361. doi:https://​doi.​org/​10.​1038/​ng.​2563.CrossRef
go back to reference Riordan, S., Rodriguez, D. F., & Kieran, S. (2012). Personal genomic testing as part of the complete breast cancer risk assessment: a case report. Journal of Genetic Counseling, 21(5), 638–644.CrossRef Riordan, S., Rodriguez, D. F., & Kieran, S. (2012). Personal genomic testing as part of the complete breast cancer risk assessment: a case report. Journal of Genetic Counseling, 21(5), 638–644.CrossRef
go back to reference Schwartz, L. M., Woloshin, S., Black, W. C., & Welch, H. G. (1997). The role of numeracy in understanding the benefit of screening mammography. Annals of Internal Medicine, 127(11), 966–972.CrossRef Schwartz, L. M., Woloshin, S., Black, W. C., & Welch, H. G. (1997). The role of numeracy in understanding the benefit of screening mammography. Annals of Internal Medicine, 127(11), 966–972.CrossRef
go back to reference Senay, I., & Kaphingst, K. A. (2009). Anchoring-and-adjustment bias in communication of disease risk. Medical Decision Making : An International Journal of the Society for Medical Decision Making, 29(2), 193–201.CrossRef Senay, I., & Kaphingst, K. A. (2009). Anchoring-and-adjustment bias in communication of disease risk. Medical Decision Making : An International Journal of the Society for Medical Decision Making, 29(2), 193–201.CrossRef
Metadata
Title
Personalized Medicine Through SNP Testing for Breast Cancer Risk: Clinical Implementation
Authors
Rebecca Howe
Talya Miron-Shatz
Yaniv Hanoch
Zehra B. Omer
Cristina O’Donoghue
Elissa M. Ozanne
Publication date
01-10-2015
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 5/2015
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-014-9803-7

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