Jonah Tischler, BA; Katherine D. Crew, MD, MS; Wendy K. Chung, MD, PhD
Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Grant Support: By the National Center for Advancing Translational Sciences of the National Institutes of Health through grant UL1TR001873.
Disclosures: Mr. Tischler reports grants from the National Center for Advancing Translational Sciences of the National Institutes of Health during the conduct of the study. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2417.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Jonah Tischler, BA, Vagelos College of Physicians and Surgeons, Columbia University, 1150 St. Nicholas Avenue, Room 620, New York, NY 10032; e-mail, email@example.com.
Current Author Addresses: Mr. Tischler and Dr. Chung: Vagelos College of Physicians and Surgeons, Columbia University, 1150 St. Nicholas Avenue, Room 620, New York, NY 10032.
Dr. Crew: Herbert Irving Comprehensive Cancer Center, Columbia University, 161 Fort Washington Avenue, Room 10-1072, New York, NY 10032.
Author Contributions: Conception and design: W.K. Chung.
Drafting of the article: J. Tischler, W.K. Chung.
Critical revision of the article for important intellectual content: K.D. Crew, W.K. Chung.
Final approval of the article: J. Tischler, K.D. Crew, W.K. Chung.
Obtaining of funding: W.K. Chung.
Collection and assembly of data: W.K. Chung.
Personalization of care through precision medicine and, more specifically, genetic testing is altering the treatment of breast cancer. Genetic testing is used in germline and tumor testing, with each providing distinct data to guide management. Germline testing supports more accurate risk evaluation to inform screening and risk-reducing medical and surgical strategies. Tumor testing can inform cancer recurrence risk assessment and cancer treatment options. This article reviews how genetic testing informs treatment and potential risks for a patient with breast cancer and her family. Hereditary cancer genetic testing of family members should include a discussion of potential results, adverse effects, clinical management options, and insurance coverage and address concerns about privacy or discrimination. Genetic professionals are available to assist with educating, testing, and treating patients with increased cancer risk.
Tischler J, Crew KD, Chung WK. Cases in Precision Medicine: The Role of Tumor and Germline Genetic Testing in Breast Cancer Management. Ann Intern Med. 2019;:. [Epub ahead of print 22 October 2019]. doi: https://doi.org/10.7326/M18-2417
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Published: Ann Intern Med. 2019.
Breast Cancer, Hematology/Oncology, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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