Beyond the Stories
Key Messages
- Hereditary cancer testing has historically been eligible to people with strong family histories of breast and ovarian cancer.
- Research has shown that we miss many families with BRCA mutations when we base testing on family history alone.
- We now know that certain forms of breast and ovarian cancer are more likely to be associated with a BRCA mutation, including triple negative breast cancer and high grade serous ovarian cancer.
- By testing individuals with these cancers, we can identify more mutations in the families of cancer patients, and prevent them from getting a breast or ovarian cancer.
If you have breast or gynecologic cancer, ask your oncologist:
- “Is my ovarian, fallopian tube or peritoneal cancer high grade serous?”
- “Is my breast cancer triple negative?”
- “Is my endometrial/uterine cancer described as missing ‘mismatch repair’ proteins?”
If your oncologist answers yes to these questions, and your breast cancer was diagnosed under age 60, ask for a referral to the hereditary cancer program.
Ask your oncologist for a referral to the hereditary cancer program if you were diagnosed with breast cancer under age 35, or you’ve had two separate breast cancers with one diagnosed under age 50.
If you do not have cancer, ask your doctor for a referral to the hereditary cancer program for BRCA testing if you have:
- A family history of breast and ovarian cancer
- A first-degree relative who had a high grade serous ovarian cancer and was never tested for a BRCA mutation. A first-degree relative is any one of your parents, siblings or children.
Rose Lee, Patient Partner
Rose was born in Hong Kong and is of Chinese descent. After she got married, she became a housewife and took care of her children. In 1987, her whole family immigrated to Vancouver, Canada. She then helped her husband to run a contractor company. She was diagnosed to have breast cancer in 2005. After her treatments she was encouraged to practice yoga by her Chinese doctor to regain her health and flexibility. She benefited from the practice and took a Kundalini Yoga Teacher Training course to support herself and share with others. She has been teaching yoga classes since 2009. In her spare time, she also enjoys volunteering at BC Cancer Center. She has met a lot of friends there and learned a lot, and overall, she finds her life quite fulfilling.
Dr. Janice Kwon, MD, FRCSC, MPH
Dr. Janice Kwon is a Gynecologic Oncologist and Associate Professor in the Department of Obstetrics and Gynecology at UBC. She completed her training in Gynecologic Oncology at the University of Toronto, Masters in Public Health at Harvard, and post-doctorate at the MD Anderson Cancer Center in Houston. Dr. Kwon is currently the Program Director for the Gynecologic Oncology subspecialty training program at UBC and the Gynecology Surgical Tumour Group Chair for BC Cancer. She serves on the Committee on Economic Analysis for the Canadian Cancer Trials Group.
Dr. Kwon’s expertise includes cost-effectiveness modeling and hereditary cancer syndromes, particularly BRCA1/2 mutations and Lynch Syndrome. Her research has influenced health policy in many jurisdictions regarding testing criteria for these cancer syndromes. These include BRCA mutation testing for women with high-grade serous ovarian cancer or triple negative breast cancer, and immunohistochemistry for mismatch repair in endometrial cancer for Lynch Syndrome. Her current research aims to improve the efficiency of BRCA mutation testing in women with ovarian cancer, which has important personal therapeutic consequences as well as downstream cancer prevention implications for family members.
Dr. Lesa Dawson, MD, FRCSC
Dr. Lesa Dawson, MD, FRCSC, trained in Medicine and Obstetrics and Gynecology at Memorial University in St. John’s followed by a fellowship in Gynecologic Oncology at the University of Calgary and a diploma in Clinical Epidemiology from Memorial. Dr. Dawson worked as a Gynecologic Oncologist for 15 years, becoming an Associate Professor in 2010. She has served on the Newfoundland Research Ethics Board as well as the Clerkship committee both as discipline and university chair. She was an active surgical teacher and was granted the 2005 Association of Professor of Obstetrics and Gynecology (APOG) Outstanding Teacher of the Year Award. Her contributions to cancer awareness and advocacy have included volunteer positions with Ovarian Cancer Canada, Canadian Cancer Society, and the Canadian Breast Cancer Foundation. She is an adjunct professor in the Division of Gynecologic Oncology at the University of British Columbia
Nationally, she is co-lead of the Gynecologic Oncology Canada Education Committee and teaches about clinical care and cancer prevention in BRCA and Lynch Syndrome carriers across Canada. Recent research projects include “Predictors of successful adherence to screening and prevention for BRCA carriers” and “Group plus “Mini-Private” Pre-test Genetic Counselling Sessions for Hereditary Cancer Predisposition Improve Patient Satisfaction and Shorten Provider Time”. Her project “Novel Gene discovery in high risk BRCA-negative Hereditary Breast Ovarian Cancer Families” received funding from the Canadian Breast Cancer Foundation 2015 and has led to the identification of a founder pathogenic variant in RAD51C causing ovarian cancer in NL.
B.C. Cancer’s Hereditary Cancer Program: The Hereditary Cancer Program provides genetic counselling and genetic testing for BC/Yukon residents who may have inherited an increased risk for specific types of cancer. Similar services are available across Canada and in other countries.
B.C. Cancer’s List of Genetic and Hereditary Cancer Websites: These websites have been compiled by B.C. Cancer Librarians.
Thank you to Michael Smith Health Research BC for Funding this project through the Reach program.
Thank you to BC Cancer Foundation, BC Women’s Health Foundation, UBC Faculty of Medicine, and VGH & UBC Hospital Foundation for supporting this project.
