Supplements

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Shari Goldman Snow, MD
Assistant Professor of Clinical Obstetrics and Gynecology
Northwestern University
Feinberg School of Medicine
Chicago, IL

Dr. Snow reports that she is a consultant and speaker for Myriad Genetics Laboratories.

As gynecologists, every day we face an increasing number of clinical issues to consider when seeing our patients. While we strive for comprehensiveness, it is important to stratify our patient care to prioritize life-threatening risk factors. Identifying a pathogenic (deleterious) hereditary cancer gene mutation allows the clinician to implement life-saving, preventive management to reduce cancer risk and improve early cancer detection. Knowing a patient’s hereditary and familial cancer risk will drive gynecologic management and decision making. Without knowing a patient’s personal and/or family history of cancer, the clinician would be unable to determine appropriate treatment options for even the simplest gynecologic issue. Therefore, for every patient at every visit, it is imperative to systematically screen for personal and family risk of cancer and to test appropriate individuals for hereditary cancer syndromes.

The following cases illustrate how knowing a patient’s hereditary cancer risk can affect the care we provide.

CASE 1: Managing fibroids—and cancer risk—in a patient with BRCA1 mutation

YH is a 40-year-old patient, G0P0, who presented for a second opinion regarding large uterine fibroids. Her previous gynecologist treated the fibroids conservatively with medication and a dilation and curettage (D&C) procedure. The patient’s menorrhagia became severe, however, leading to anemia. A hysterectomy was recommended, but the patient wanted a second opinion to discuss options for preserving her uterus.

Click here to download the PDF.

Shari Goldman Snow, MD
Assistant Professor of Clinical Obstetrics and Gynecology
Northwestern University
Feinberg School of Medicine
Chicago, IL

Dr. Snow reports that she is a consultant and speaker for Myriad Genetics Laboratories.

As gynecologists, every day we face an increasing number of clinical issues to consider when seeing our patients. While we strive for comprehensiveness, it is important to stratify our patient care to prioritize life-threatening risk factors. Identifying a pathogenic (deleterious) hereditary cancer gene mutation allows the clinician to implement life-saving, preventive management to reduce cancer risk and improve early cancer detection. Knowing a patient’s hereditary and familial cancer risk will drive gynecologic management and decision making. Without knowing a patient’s personal and/or family history of cancer, the clinician would be unable to determine appropriate treatment options for even the simplest gynecologic issue. Therefore, for every patient at every visit, it is imperative to systematically screen for personal and family risk of cancer and to test appropriate individuals for hereditary cancer syndromes.

The following cases illustrate how knowing a patient’s hereditary cancer risk can affect the care we provide.

CASE 1: Managing fibroids—and cancer risk—in a patient with BRCA1 mutation

YH is a 40-year-old patient, G0P0, who presented for a second opinion regarding large uterine fibroids. Her previous gynecologist treated the fibroids conservatively with medication and a dilation and curettage (D&C) procedure. The patient’s menorrhagia became severe, however, leading to anemia. A hysterectomy was recommended, but the patient wanted a second opinion to discuss options for preserving her uterus.

Click here to download the PDF.

Shari Goldman Snow, MD
Assistant Professor of Clinical Obstetrics and Gynecology
Northwestern University
Feinberg School of Medicine
Chicago, IL

Dr. Snow reports that she is a consultant and speaker for Myriad Genetics Laboratories.

As gynecologists, every day we face an increasing number of clinical issues to consider when seeing our patients. While we strive for comprehensiveness, it is important to stratify our patient care to prioritize life-threatening risk factors. Identifying a pathogenic (deleterious) hereditary cancer gene mutation allows the clinician to implement life-saving, preventive management to reduce cancer risk and improve early cancer detection. Knowing a patient’s hereditary and familial cancer risk will drive gynecologic management and decision making. Without knowing a patient’s personal and/or family history of cancer, the clinician would be unable to determine appropriate treatment options for even the simplest gynecologic issue. Therefore, for every patient at every visit, it is imperative to systematically screen for personal and family risk of cancer and to test appropriate individuals for hereditary cancer syndromes.

The following cases illustrate how knowing a patient’s hereditary cancer risk can affect the care we provide.

CASE 1: Managing fibroids—and cancer risk—in a patient with BRCA1 mutation

YH is a 40-year-old patient, G0P0, who presented for a second opinion regarding large uterine fibroids. Her previous gynecologist treated the fibroids conservatively with medication and a dilation and curettage (D&C) procedure. The patient’s menorrhagia became severe, however, leading to anemia. A hysterectomy was recommended, but the patient wanted a second opinion to discuss options for preserving her uterus.

Click here to download the PDF.

EXECUTIVE SUMMARY

This article addresses the importance of hereditary cancer panel testing. No longer are single syndrome tests the best diagnostic for hereditary cancer risk. Panel testing addresses multiple genes that are associated with a single cancer, as well as single genes that implicate multiple cancers.

To optimize patient care, it is important to determine who is the best candidate within a family to test, and identify laboratories with the greatest accuracy in results.

Click here to download the PDF.

EXECUTIVE SUMMARY

This article addresses the importance of hereditary cancer panel testing. No longer are single syndrome tests the best diagnostic for hereditary cancer risk. Panel testing addresses multiple genes that are associated with a single cancer, as well as single genes that implicate multiple cancers.

To optimize patient care, it is important to determine who is the best candidate within a family to test, and identify laboratories with the greatest accuracy in results.

Click here to download the PDF.

EXECUTIVE SUMMARY

This article addresses the importance of hereditary cancer panel testing. No longer are single syndrome tests the best diagnostic for hereditary cancer risk. Panel testing addresses multiple genes that are associated with a single cancer, as well as single genes that implicate multiple cancers.

To optimize patient care, it is important to determine who is the best candidate within a family to test, and identify laboratories with the greatest accuracy in results.

Click here to download the PDF.

A failed in vitro fertilization (IVF) cycle is always a disappointment for the patient. When multiple cycles fail, patients often turn to their nurses for support and perspective.

How many times has an IVF nurse heard the following:

My embryos were highly graded and I am healthy with normal fertility testing, yet I did not get pregnant. What went wrong?

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A failed in vitro fertilization (IVF) cycle is always a disappointment for the patient. When multiple cycles fail, patients often turn to their nurses for support and perspective.

How many times has an IVF nurse heard the following:

My embryos were highly graded and I am healthy with normal fertility testing, yet I did not get pregnant. What went wrong?

Click here to download the PDF.

A failed in vitro fertilization (IVF) cycle is always a disappointment for the patient. When multiple cycles fail, patients often turn to their nurses for support and perspective.

How many times has an IVF nurse heard the following:

My embryos were highly graded and I am healthy with normal fertility testing, yet I did not get pregnant. What went wrong?

More than one-third of adults and one-sixth of children and adolescents in the United States are obese (ie, body mass index [BMI] ≥30 kg/m2).¹ This is more than double the prevalence in 1994).² Also of great concern, is that the prevalence of extreme obesity (BMI ≥40 kg/m2) rose from 3.9% to 6.6% in the United States from 2000 to 2010, a 70% increase.³ As primary care providers, family physicians contend on a daily basis with cardiovascular and other health consequences of this burgeoning epidemic.

More than one-third of adults and one-sixth of children and adolescents in the United States are obese (ie, body mass index [BMI] ≥30 kg/m2).¹ This is more than double the prevalence in 1994).² Also of great concern, is that the prevalence of extreme obesity (BMI ≥40 kg/m2) rose from 3.9% to 6.6% in the United States from 2000 to 2010, a 70% increase.³ As primary care providers, family physicians contend on a daily basis with cardiovascular and other health consequences of this burgeoning epidemic.

More than one-third of adults and one-sixth of children and adolescents in the United States are obese (ie, body mass index [BMI] ≥30 kg/m2).¹ This is more than double the prevalence in 1994).² Also of great concern, is that the prevalence of extreme obesity (BMI ≥40 kg/m2) rose from 3.9% to 6.6% in the United States from 2000 to 2010, a 70% increase.³ As primary care providers, family physicians contend on a daily basis with cardiovascular and other health consequences of this burgeoning epidemic.

Click here to download the PDF.

As Obstetrician-Gynecologists, we are charged with caring for women through every stage of their lives. From puberty to reproduction to menopause and beyond, we ensure that everything we do for our patients is in their short- and long-term best medical interests. We must continuously assess their risk factors in order to make medical and lifestyle recommendations that are most appropriately suited to each individual woman's need. One area of risk assessment often overlooked in our female patients is hereditary and familial cancer risk. The following is my journey of integrating hereditary cancer risk assessment (HCRA) into my everyday practice, and understanding it as fundamental to standard of care.

Click here to download the PDF.

As Obstetrician-Gynecologists, we are charged with caring for women through every stage of their lives. From puberty to reproduction to menopause and beyond, we ensure that everything we do for our patients is in their short- and long-term best medical interests. We must continuously assess their risk factors in order to make medical and lifestyle recommendations that are most appropriately suited to each individual woman's need. One area of risk assessment often overlooked in our female patients is hereditary and familial cancer risk. The following is my journey of integrating hereditary cancer risk assessment (HCRA) into my everyday practice, and understanding it as fundamental to standard of care.

Click here to download the PDF.

As Obstetrician-Gynecologists, we are charged with caring for women through every stage of their lives. From puberty to reproduction to menopause and beyond, we ensure that everything we do for our patients is in their short- and long-term best medical interests. We must continuously assess their risk factors in order to make medical and lifestyle recommendations that are most appropriately suited to each individual woman's need. One area of risk assessment often overlooked in our female patients is hereditary and familial cancer risk. The following is my journey of integrating hereditary cancer risk assessment (HCRA) into my everyday practice, and understanding it as fundamental to standard of care.