Will cancer genomic testing help guide my next steps?

Question

Hello doctor,

I am a 44-year-old woman who recently underwent a lumpectomy for early-stage breast cancer. During our last consultation, you mentioned the possibility of cancer genome testing to inform further treatment decisions.

I have a few questions and would appreciate your guidance:

Is the cancer genome testing you referred to the same as genetic testing for BRCA mutations, or do they differ?
Can the results of this genomic testing help determine whether chemotherapy is necessary in my case?
I have daughters and am concerned about their potential risk. Will this testing provide insights into their susceptibility to breast cancer?

Navigating the terminology and understanding the implications of these tests is quite overwhelming. Could you please explain, in layman's terms, how genomic testing works, what the possible outcomes mean, and whether it is advisable in my situation? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I completely understand your concerns.

Genetic and genomic testing are distinct yet complementary tools in cancer care.

Genetic testing: This assesses inherited mutations, such as BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2), which can increase an individual's risk for certain cancers, including breast and ovarian cancers. Identifying these mutations can inform preventive strategies and guide family members on their potential risks.
Genomic testing: This examines the genes within cancer cells to understand the tumor's behavior. It provides insights into which treatments, like chemotherapy (drugs to kill fast-dividing cells, both cancerous and some healthy ones, to stop tumor growth and prevent spread) or hormonal therapy (targets cancers that depend on hormones like estrogen, progesterone, or testosterone to grow), may be most effective for a specific cancer type.

Recommendations for your daughter's health:

Given the significance of inherited mutations like BRCA1 and BRCA2, I recommend considering genetic testing for your daughter. This can provide clarity on her cancer risk and inform appropriate screening strategies.

For breast cancer screening:

Women under 40: Routine mammograms (low-dose X‑ray imaging test specifically for the breasts, which is for early detection of breast cancer, capable of revealing tiny tumors) are generally not recommended unless there is a significant family history or other risk factors.
Women aged 40 and above: Annual mammograms are advised to detect any early signs of breast cancer.

It is essential to consult with a healthcare provider to determine the most appropriate screening schedule based on individual risk factors.

I hope this helps.

Kindly revert if there is any query.

Thank you.