Acknowledgement: This course is supported by educational grants from Celera and the Applera Charitable Foundation.

In this course, a 36-year-old woman presents with concerns about her family history of cancer. Her cousin has recently been diagnosed with breast cancer at age 29. She wants to know if she should start to have mammograms and/or MRIs and if she should have genetic testing.

This case provides an overview of hereditary breast and ovarian cancer while addressing the synthesis of risk data, testing strategies, and screening guidelines.

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

COST: $20.00 for the average learner. Participants living in emerging nations receive a 50% discount or can register for free. See our International Pricing Page for details.

OVERALL LEARNING OBJECTIVES:

At the conclusion of this case study participants will be better able to:

1. Identify the genetic syndromes associated with breast cancer and the genes responsible for these syndromes.
2. Use and understand models available to predict risk of breast cancer.
3. Understand the testing algorithm for individuals and families where hereditary breast cancer is suspected.
4. Understand the management options for individuals who are carriers of deleterious BRCA mutations.

METHOD OF PARTICIPATION:

Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.

COMBINATION OF MEDIA USED:

This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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KEVIN HUGHES, MD Course Co-Director

Kevin S. Hughes, M.D. is Co-Director of the Avon Comprehensive Breast Evaluation Center and Surgical Director of the Breast and Ovarian Cancer Genetics and Risk Assessment Program at the Massachusetts General Hospital. He is Medical Director of the Bermuda Cancer Genetics and Risk Assessment Clinic. Dr. Hughes is Associate Professor of Surgery, Harvard Medical School, and a member of the Department of Surgical Oncology at the Massachusetts General Hospital. He is a graduate of Dartmouth College and Dartmouth Medical School. Dr. Hughes trained at the Mercy Hospital of Pittsburgh for general surgery, followed by a fellowship in surgical oncology at the National Cancer Institute. Dr. Hughes was formerly on the faculty of Tufts University, the University of California, Davis and Brown University. He is actively involved in research regarding the genetics, screening, diagnosis and treatment of breast cancer and is actively involved in the development of Electronic Health Records that decrease clinician workload. He co-authored the HL7, ANSI approved standard for transmitting family health history. DISCLOSURE: Myriad Genetics Speakers Bureaus Content area: Hereditary Cancer/Genetics Testing

RAJU KUCHERLAPATI, PhD Course Co-Director

Raju Kucherlapati, Ph.D. is the Scientific Director of the Harvard Medical School-Partners HealthCare Center for Genetics and Genomics (HPCGG) and the Paul C. Cabot Professor of Genetics and Professor of Medicine at Harvard Medical School (HMS). He is the first Scientific Director of HPCGG. Dr. Kucherlapati was a member of the consortium to map and sequence the human and mouse genomes. His research interests are in the areas of discovery and characterization of human disease genes using a combination of human and mouse genetic and genomic approaches. He was a member of the National Advisory Council for Human Genome Research at the National Human Genomics Research Institute, co-chair of the steering committee for the National Cancer Institute’s Mouse Models for Human Cancer Consortium and served on the editorial board of the New England Journal of Medicine and was editor in chief of the journal Genomics. He is a fellow of the American Association for the Advancement of Science (AAAS). DISCLOSURE: Reported no relevant financial relationships with commercial entities

CONSTANCE A. ROCHE, MSN, ANP-B Course Co-Director

Connie Roche is a nurse practitioner at Massachusetts General Hospital in the Avon Comprehensive Breast Evaluation Center and the Breast and Ovarian Cancer Risk and Prevention Program. She received her B.S.N. from Northeastern University, and her Masters Degree as an Adult Nurse Practitioner from Simmons College. She is a certified Oncology Nurse and an Advance Practice Nurse in Genetics. Her responsibilities include the evaluation and clinical management of women with breast cancer or benign breast problems. In addition, she has expertise in assessing women for breast and ovarian cancer risk providing counseling and education about cancer risk, cancer genetics, screening and risk reduction strategies. She has published and speaks locally and nationally on the subjects of evaluation of breast problems, breast cancer risk, cancer genetics, and the development of a cancer risk assessment program. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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SUSAN CARO, RNC, MSN Reviewer

Susan Caro is Director of the Family Cancer Risk Service of the Vanderbilt-Ingram Cancer Center, and Instructor in the Vanderbilt University School of Nursing. She provides cancer risk assessment and education concerning hereditary risk of cancer, including hereditary breast cancer syndromes, colorectal cancer syndromes, and other cancer syndromes to individuals and families. She received her Bachelor of Science in Nursing from Vanderbilt University in 1977, and her Masters of Science in 1983. She is a Women’s Health Nurse Practitioner, and was one of the first 13 individuals to be awarded the credential, “Advanced Practice Nurse in Genetics” from the International Society of Nurses in Genetics in October 2001. In 2000 she was honored with the Frances Williams Preston Award for Breast Cancer Awareness and was named the Susan G. Komen Foundation BMW Ultimate Drive Local Hero for her efforts in breast and hereditary cancer awareness. She has authored several chapters on breast cancer risk with Dr. David Page. DISCLOSURE: Quest Diagnosis (sister is account services representative) Content area: Laboratory services (not related to BRCA1 or BRCA2 testing).

JULIE SILVER, MD Reviewer

Julie Silver, MD is an assistant professor at Harvard Medical School in the Department of Physical Medicine and Rehabilitation. As a physiatrist, her work focuses on helping cancer survivors to function at the highest possible level. Dr. Silver is an award-winning author who wrote After Cancer Treatment: Heal Faster, Better, Stronger (Johns Hopkins Press) and What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope (American Cancer Society). DISCLOSURE: Oncology Rehab Partners, Co-Founder/Cancer Rehabilitation

NADINE TUNG, MD Reviewer

Dr. Tung is Director of the Cancer Risk and Prevention Program at Beth Israel Deaconess Medical Center in Boston. She is an Assistant Professor of Medicine at Harvard Medical School and a member of the Breast Cancer program and the Breast SPORE at the Harvard/Dana Farber Cancer Center. Dr. Tung received her MD at Harvard and served as intern, resident, and chief resident in medicine at the Beth Israel Hospital in Boston, and completed her fellowship in Hematology / Oncology at Beth Israel as well. Dr.Tung’s research interests include prevention and treatment of breast cancer in BRCA1 and BRCA2 mutation carriers as well as hereditary and environmental factors which influence cancer expression in these women. She is currently a co-investigator in clinical trials using PARP inhibitors and is active in studies evaluating the optimal treatment of triple negative breast cancers. She was a P.I. at Beth Israel for the STAR (P-2) trial evaluating the effectiveness of tamoxifen and raloxifene in breast cancer prevention. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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SANJIV CHOPRA, MD Planner

Dr. Sanjiv Chopra is Professor of Medicine and Faculty Dean for Continuing Medical Education at Harvard Medical School and Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. In his role as Faculty Dean for Continuing Education, Dr. Chopra provides oversight and leadership of the Department and oversees the academic development of our programs. Dr. Chopra is an experienced clinician, researcher, and educator. In his research roles, he has served both as a principal investigator as well as co-investigator. He has more than 120 publications and five books to his credit, addressing topics in disease states, patient care, and leadership. Dr. Chopra’s teaching experience is extensive, and he has won numerous teaching awards for his work with medical students, residents and physicians. Currently, he directs and speaks at 10 multiday CME courses, nine of which are through HMS. For his full bio, please click here. DISCLOSURE: Reported no relevant financial relationships with commercial entities

ERIN HARVEY, MSC, CGC Planner

Erin K. Harvey, MSc, CGC, was the Assistant Director of Education for Partners Healthcare Center for Personalized Genetic Medicine (PCPGM) from 2008 to 2011. She is a board-certified genetic counselor and has worked with a wide range of primary healthcare professionals in the development of genetics-related, case-based continuing medical education (CME). In addition to being the series editor for PCPGM’s genetics CMEs, she coordinated an advanced human genetics course for Harvard Medical School’s Clinical Genetics Residency training program. In 2011, she accepted a position with Genzyme as a Scientific Communications Principal for the Personalized Genetic Health division. Prior to joining PCPGM, Ms. Harvey spent five years with the National Coalition for Health Professional Education in Genetics, and was seconded for one year to the United Kingdom to help a similar organization there – the National Genetics Education and Development Centre – create genetics resources for the UK’s nationalized medical education curriculum. Ms. Harvey received her master’s degree in science in 2003 from the Johns Hopkins University/National Institutes of Health joint genetic counseling training program. She received a B.A. in English Writing from St. Edward’s University in Austin, Texas in 1993, and worked as a journalist prior to pursuing a career in the biological sciences. DISCLOSURE: Reported no relevant financial relationships with commercial entities

ANDI LONG, EDM Planner

Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College, summa cum laude, with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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NUMBER OF CREDITS: 1 

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate

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