How Genetic Testing Has Changed for Patients With Breast Cancer

Kevin Hughes, MD, medical director at the Bermuda Cancer Genetics and Risk Assessment Clinic, codirector of the Avon Breast Evaluation Program at Massachusetts General Hospital, and associate professor of surgery at Harvard Medical School, discusses how genetic testing has changed and how much testing should be done for patients with breast cancer.

Hughes explains that in the past, genetic testing was only used to findBRCA1andBRCA2, the 2 major genes that cause cancer susceptibility. Over the years, testing has become much less expensive, which means patients can be tested for anywhere from 40 to 80 genes for the same price of testing 20 years ago for only 1 or 2 genes.

The tests used now are called panel testing, where patients are tested for multiple genes that can cause cancer. Some physicians who order panel testing limit the test to only breast cancer genes, whereas other will test all of the genes. In Hughes opinion, the more genes that are tested, the better because you may identify things you may not have originally expected. He says he would go for the biggest, longest panel he can find; the more genes the better to find out what mutations the patients have so he can manage them appropriately. Hughes feels that panel testing is the best option, and bigger panels are better for these patients.

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