Genetic Counseling & Testing

Griffin Health offers peace of mind for individuals at risk for cancer with its High-Risk Breast Cancer Clinic and Genetic Counseling & Testing Services at The Center for Cancer Care, helping individuals understand their chances for developing cancer, providing an individualized cancer screening schedule and preventive treatment options.

What is hereditary cancer?

All cancer is caused by harmful changes, known as mutations, in a person’s genes. Many mutations happen by chance and others are thought to be caused by lifestyle and environmental factors. Other mutations, however, are passed down through our family and can be related to hereditary cancer.

People at risk for hereditary cancer may develop more than one cancer and their cancer often happens at an earlier than average age. All individuals with a family history of cancer, including breast and ovarian, should consider genetic testing.

Know your risk

Understanding your risk for hereditary cancer starts with knowing your personal and family history, such as:

• Knowing the history of cancer on your mom and dad’s side of the family
• Knowing at least three generations of cancer history (parents, children, siblings, grandparents, aunts, uncles, nieces, nephews, and other close blood relatives)
• Knowing details such as the type of cancer and what age your relative was when they were diagnosed

Why is hereditary cancer testing important?

If you have a family history of cancer, hereditary cancer testing is the primary way to find out if you are at hereditary, familial, or general population risk. This information helps you and your care team make informed healthcare decisions.

People with familial or hereditary cancer risk have a higher chance of developing cancer during their lifetime. Knowing if you are at higher risk for cancer empowers you to make lifesaving medical management decisions. You and your care team can create a personalized plan to reduce your risk of developing cancer, or increase the likelihood of finding cancer at an earlier and more treatable stage.

• Your personalized prevention or treatment plan may include:
• Extra surveillance to find cancer at an earlier and more treatable stage
• Risk-reducing medications to lower the risk for certain cancers
• Risk-reducing surgery, based on your unique situation, to greatly lower your risk
• Cancer treatment options determined through genetic testing

Red flags for hereditary cancer

If you can answer yes to any of the questions below, you may be a good candidate for hereditary cancer testing:

• At any age, you have a personal history of: Breast Cancer, Ovarian Cancer, Prostate Cancer, Pancreatic Cancer, Colorectal, Endometrial or Uterine cancer.
• You have a family history of:
  • Breast cancer at age 50 or younger
  • Ovarian cancer or male breast cancer at any age
  • Ashkenazi Jewish ancestry AND have a relative diagnosed with breast cancer
  • A first-degree relative with pancreatic, colon, rectal, or endometrial cancer at age 49 or younger
  • A gene mutation found in a family member

Breast cancer specific factors

The Hewitt Center for Breast Wellness High Risk Breast Cancer Clinic provides genetic counseling for individuals with a personal and/or family history of:

• Breast or ovarian cancer
• Breast cancer diagnosed before age 45
• Multiple cases of breast cancer on the same side of the family
• Ovarian cancer in a family with breast cancer
• Male breast cancer
• Multiple cases of pancreatic cancer on the same side of the family
• The combination of breast, ovarian, and/or pancreatic cancer on the same side of the family or in a single individual
• Jewish ancestry in combination with any of the above
• Jewish ancestry and even one case of breast or ovarian cancer (even in the absence of additional family history)
• Medullary breast cancer and triple negative breast cancer are over-represented in women with hereditary breast and ovarian cancer

Colon cancer specific factors

The Center for Cancer Care at Griffin Hospital provides colon cancer genetic counseling for individuals with a personal and/or family history of:

• Colon cancer diagnosed before age 50
• Multiple cases of colon cancer on the same side of the family
• The combination of colon, uterine, ovarian, urinary tract, and/or other gastrointestinal cancers on the same side of the family
• A single individual with colon and uterine cancer, more than one separate colon cancer diagnosis, or colon and ovarian cancer
• Even one sebaceous carcinoma
• A colon cancer in which screening tests (called microsatellite instability (MSI) and/or immunohistochemistry (IHC)) have indicated an increased risk for hereditary colon cancer
• Multiple colon polyps (adenomatous, hamartomatous, or juvenile)

How genetic testing for hereditary cancer works

If you have any of the red flags for hereditary cancer, call the Griffin Health High Risk Clinic at 203-732-7233 for an appointment. You will speak to a genetic counselor and a full history and risk assessment will be performed. If you meet criteria for genetic testing, a sample can be collected for analysis. When the results are available, you will be called for an appointment with a provider to discuss your results and create an individualized plan for cancer screening.

Depending upon your initial counseling, a blood or saliva sample is collected at The Center for Cancer Care at Griffin Hospital using a special kit, which will be shipped to Myriad Genetics for analysis. Test results will be delivered to the Center in approximately two weeks, and a physician at the Center for Cancer Care or the High-Risk Breast Cancer Clinic will meet with you to discuss your results.

Genetic Testing FAQs

• Who is a candidate for genetic counseling?

  Individuals who have a personal and/or family history that includes risk factors for hereditary cancers may benefit from our program. These risk factors include multiple relatives on the same side of the family with the same cancer or related cancers, cancer at unusually early ages, more than one diagnosis of cancer in the same individual, rare cancers, or a family history of a known altered cancer-predisposing gene.

• Can I just have genetic testing without counseling?

  We do not offer testing alone. Counseling is an integral part of the testing process and is essential to ensure that the correct test is ordered and for accurate result interpretation and medical management.

• How would I use the results of genetic counseling and testing?

  This information will help to estimate a person’s true risks of developing cancer, and to develop a personalized plan for surveillance and management based on those risks. It can also be very useful to the entire family. We discuss these issues, in depth, in the counseling sessions.

• Will my insurance pay for genetic counseling?

  95% of private insurance companies have coverage for hereditary cancer testing.

• Is the program part of a research study or a clinical service?

  Cancer genetic counseling and testing are now offered as a clinical service. However, if you are seen by our program, we will invite you to participate in our data repository, which allows us to share deidentified data with current and future studies to advance research in this area. In addition, depending upon your personal and/or family history, you may be invited to participate in other research studies that are available through our program.

• What information should I bring to my first counseling session?

  The more information you give us, the more accurate your counseling will be. We can collect some of the following information after your first session; however, it would be ideal for you to collect it and bring it to your first appointment.

  • If you have had cancer, please bring us a copy of your pathology reports before your first appointment.
  • We will be asking you questions about your family members, particularly your brothers, sisters, parents, children, grandparents, aunts, uncles, nieces, nephews and cousins. If any of them have had cancer, please find out the primary site of the cancer and their age at diagnosis. Pathology reports are very helpful.
  • If any of your family members have had genetic testing, please bring us a copy of the actual test results.

• Do I need a referral from my physician for genetic testing?

  Our program does not require a referral, but your insurance may require one. Please check with your particular carrier and policy on this issue.

• How long will it take me to schedule an appointment?

  Appointments are typically scheduled one-to-two months ahead of time. Exceptions are made for medical emergencies.