CD-ROM Helps Women Check Breast Cancer Risk
Breast Cancer Teaching Tools Help Women Measure Risk, Treatment Options
July 27, 2004 -- A "virtual counselor" can help women at high risk of breast cancer decide what steps they should take next.
Researchers from Penn State College of Medicine say their interactive computer program can help worried women decide if they need additional counseling and genetic testing.
Their program is one of two new patient education tools highlighted in the July 28 issue of TheJournal of the American Medical Association. A second study evaluated a decision aid designed to help women with breast cancer choose between mastectomy and breast-conserving surgery.
In an editorial accompanying the two studies, cancer geneticist Charis Eng, MD, PhD, and colleague Dirk Iglehart, MD, write that such educational tools will become more important as more genetic tests and treatment options become available.
"I think in theory these types of educational tools are fantastic," Eng tells WebMD. "There is a horrible shortage of genetic counselors and a shortage in the surgical field, as well. These tools can take the place of counseling for some women and help other women get more out of counseling."
Breast Cancer Genes
Each year, more than 192,000 women in the U.S. are diagnosed with breast cancer. The National Cancer Institute estimates that between 5% and 10% of breast cancer cases have a genetic component, and mutations in the BRCA1 and BRCA2 genes are involved in up to 70% of all inherited breast cancers.
It's unclear how much these gene mutations increase a woman's risk of breast cancer. However, medical research has estimated that these women have between a 36% and 85% chance of developing breast cancer during their lifetime. This is significantly less than the lifetime risk of about 13% for women without the mutations.
Michael J. Green, MD, and Penn State colleagues developed their interactive, CD ROM-based teaching tool to help women with a family history understand their individual risks. Green tells WebMD that the computer program includes general information about breast cancer as well as detailed information about hereditary risks and the pros and cons of genetic testing.
"The program was designed to help women make informed decisions about whether or not genetic testing made sense for them," he says.
The study included 211 women seeking genetic breast cancer counseling at six clinics in the U.S. Either the woman or someone in her family had a history of breast cancer. Half received standard one-on-one genetic counseling, and the other half completed the computer program followed by genetic counseling.
The computer program was found to be a very effective teaching tool and was all that most of the lower-risk women needed, Green says. Women at higher risk, however, benefited from individual testing.
The CD-ROM is available for purchase through Medical Audio Visual Communications Inc., (800) 757-4868. The National Cancer Institute also offers a free overview of genetics and breast cancer in its report, "Genetic Testing for BRCA1 and BRCA2: It's Your Choice." The report is available on the NCI web site (http://cis.nci.nih.gov/fact/3_62.htm).
"Right now there are just a handful of genetic tests, but over the next decade hundreds and hundreds more may become available," Green says. "If patients are going to make informed decisions about whether they need a certain test, they are going to need new sources of information."