kevin s.hughes, md, facs co-director, avon comprehensive breast evaluation center massachusetts...
TRANSCRIPT
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Kevin S.Hughes, MD, FACSCo-Director, Avon Comprehensive Breast Evaluation Center
Massachusetts General Hospital
SurgeonThe Newton-Wellesley Hospital Breast Center
Computer Solutions to Identify and Manage Women at High Risk
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Reviews Report
Reviews suggestedManagement
Adds clinical information
Documents and Orders
Patient education
al materials
Clinical Decision Support
Patient enters data : Tablet PC
iPadWebsite
Clinical Decision Support
EHR
EHR
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Demo
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Our Goal
Find every mutation carrier for every
hereditary syndrome known to man before
disease occurs
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Cancer Risk
Breast 63% 55%
Ovary 58% 30%
Breast 6%
Female
Male
BRCA1 BRCA2
BRCAPRO
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BRCA1/2 Mutation carriers in the US
~1,000,000 carriers
~350,000 females 20 and older
n CarriersJewish
(1/40) 6,191,281 154,782
Not Jewish(1/350) 275,230,624 786,373
281,421,906 941,155
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15 years of genetic testing• BRCA tests to date
– ~500,000
• Assume 10% positive– 50,000 BRCA1/2 carriers found
• Assume most tested patients had cancer– 95 to 99% of unaffected carriers not tested
Likely the best of any adult hereditary syndrome
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Family history
Multiple relatives affected
Young age at diagnosis
Multiple primary cancers
Unusual CancerMale breast cancer
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BRCAPRO
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Options for high risk
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Prophylactic Oophorectomy
Screening
Chemoprevention
Options for high risk
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