Breakthrough advances in the diagnosis and treatment of breast and ovarian cancer were presented at a program for health professionals Sunday, March 18, at Northside Hospital.
“Global Breakthroughs in Awareness, Research and Treatment of Breast and Ovarian Cancer” was presented by Hadassah Greater Atlanta and sponsored by Northside. It preceded that night’s Hadassah Greater Atlanta fundraiser for breast and ovarian cancer, Best Strokes, at which more than $36,000 was raised.
Dale Bearman, who serves on the Northside Hospital board and was the tearful Best Strokes honoree for his efforts to expand use of genetic testing for cancer, moderated a panel consisting of Tamar Peretz, the director of the Sharett Oncology Institute at the Hadassah Medical Organization in Jerusalem; Benedict Benigno, the director of gynecological oncology at the Northside Hospital Cancer Institute and founder and CEO of the Ovarian Cancer Institute; and Jayanthi Srinivasiah, a medical oncologist and hematologist for Georgia Cancer Specialists and the Northside Hospital Cancer Institute.
Peretz also was the honorary chair of the Best Strokes fundraiser, at which she spoke about Hadassah’s advances in cancer research.
Benigno spoke of his dreams of better treatment to cure cancer. Treatments individualized to each patient may be possible to eliminate the need for chemotherapy and surgery.
Information technology speeds research, and multidisciplinary teams will work together for an integrated approach to develop testing and designer drugs for targeted, personalized therapy.
He also discussed the need for early identification of ovarian cancer. There are no early signs or symptoms, and the cancer may be too advanced for best outcomes once it is discovered. Early screenings are critical.
Benigno, working with Georgia Tech, developed a test to identify Stage 1 ovarian cancer and is seeking Food and Drug Administration approval.
Peretz was part of an international team that first identified the BRCA1 and BRCA2 genetic link to breast and ovarian cancers. The BRCA gene mutation is 10 times more frequent among Ashkenazi Jewish women than in the general population.
Advances in genetic research have refined diagnosis and treatment through the identification of molecular subtypes. Five subgroups were identified that differ because of their aggressiveness and receptivity to treatment options for the best results.
Srinivasiah gave a detailed talk on the genetics of cancer. She repeated the other speakers’ data that only 5 percent to 10 percent of breast and ovarian cancers result from the inherited genetic mutation linked to the BRCA1 and BRCA2 mutations, but those mutations increase the lifetime risk for one or more types of cancer, with a 70 percent chance of cancer by age 70.
The gene can be inherited from either the mother or the father, and she recommends that fathers be tested if the mother is negative for the BRCA mutation
Exciting advances in genetic testing can be appropriate to identify risks and treatment options for concerned people. Srinivasiah stressed the importance of genetic counseling before testing to determine the need for such tests and to review the results when testing is indicated.
Preventive treatment when the BRCA gene mutations are present may include a double mastectomy or the removal of ovaries. Testing of breast cancer tumor genes can guide the medical team on the best treatment for optimal outcomes.
Familial correlations account for 15 percent to 20 percent of cancers and are defined as more cancers occurring in a family than expected in a normal family, with no genetic reason identified. There may be an unidentified genetic reason or an environmental risk.
Sporadic cancers, which account for 70 percent to 80 percent of cases, have no known exact cause, with no hereditary features in familial cancers.
New genetic tests are coming to identify mutations that can cause cancer. Multipanel genetic testing for the patient with cancer can identify whether there is a genetic cause and help the family.
Srinivasiah recommends that patients and families obtain genetic counseling to determine whether and which tests are to be conducted. Although commercial genetic testing for some cancers is becoming available to consumers, a second test for confirmation of findings is recommended. Pharmacogenetics is another use of genetic testing to identify the best medications to treat cancer.
The interdisciplinary panel presented an encouraging view of current and future breakthroughs for the awareness, research and treatment of breast and ovarian cancers.