The growing practice of genetic counselling

Angelina Jolie recently revealed in a New York Times editorial that she’d undergone a preventive double mastectomy. Since then, the importance of genetic counselling has been in the spotlight. The actress had discovered that she carries the BRCA1 gene mutation, which sharply increases the risk of developing breast cancer and ovarian cancer. The mutation is rare, occurring in only 5 to 10 percent of breast cancer cases and approximately 10 to 15 percent of ovarian cancer cases in Caucasian women. The risk of developing breast or ovarian cancer is much higher in women with the BRCA1 gene mutation than in non-carriers, but it can vary greatly from one woman to another. Not every woman will have the same risk level as Angelina Jolie. Only a medical team trained in genetic testing can determine a woman’s specific risk. A woman’s reaction to her risk level is highly personal: some decide to undergo more regular screenings, others opt for preventive surgery. In this field, there is no “right” or “wrong” decision. Who should undergo genetic testing? Genetic counselling is offered in Quebec when doctors suspect genetics may be involved in a cancer case or a series of cases within a family. Generally, genetic testing is only considered for women who have a mutation risk of at least 10 percent. For example, candidates are usually women with a female family member known to have a mutation, or women from families with several cases of breast or ovarian cancer.