Hereditary Breast and Ovarian Cancer: Structures of Care in Austria

Abstract

Mutations in the BRCA1 or BRCA2 genes result in a significantly increased risk of breast and ovarian cancer. Austrian women who carry a BRCA1 mutation have a risk of 85% for breast cancer and 53% for ovarian cancer up to 70 years of age. At-risk women have 2 medical options: closely monitored early detection using mammography, breast ultrasound, and MRI, as well as tumor markers and vaginal ultrasound, or real risk reduction through prophylactic removal of the breast tissue and/or the ovaries. As awareness of such a high risk of disease may cause a great deal of distress, and because prophylactic surgeries offer only very drastic measures for risk reduction, a special multidisciplinary care concept is of particular importance. This care starts with comprehensive genetic counseling before performing molecular genetic analysis and must be continued after a genetic predisposition for breast and ovarian cancer has been identified. Right from the start, special schooling in Austria has ensured that patients in all cooperating genetic counseling centers are counseled, selected, and followed- up according to the same criteria.