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 educational activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

COST: $20.00
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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.

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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:

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:

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:

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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:

JULIE SILVER, MD Reviewer

Julie K. Silver, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. Dr. Silver has expertise in oncology rehabilitation and founded a program called RESTORE to help cancer survivors physically recover from toxic treatments. Dr. Silver is an award-winning writer and has published more than twenty books that focus on helping people to physically recover from serious injuries and illnesses. She is the Chief Editor of Books at Harvard Health Publications (the consumer health branch of Harvard Medical School). She is the co-editor of one of the major textbooks in her medical specialty titled The Essentials of Physical Medicine and Rehabilitation (Elsevier). Library Journal named her trade book, After Cancer Treatment: Heal Faster, Better, Stronger (Johns Hopkins University Press) one of the top twenty health books released in 2006. Dr. Silver’s work in oncology rehabilitation was recognized by the American Cancer Society in 2006 when she was awarded the prestigious Lane Adams Quality of Life award. DISCLOSURE:

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:

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NUMBER OF CREDITS: 1 

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

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

Upon completion of the course you will get a certificate via e-mail within 2 weeks.

Click the image to view a sample of the certificate

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