Strong Family History of Breast and Ovarian Cancer/BRCA Gene Mutation Carriers
Suggested Pre-Referral Evaluation and Management Guidelines
Consider visit with genetic counselor (Dr. Merajver's office - Kara Milliron)
Tamoxifen and Raloxifene
Prophylactic surgery (bilateral salpingo-oophorectomy [BSO] and/or mastectomy) are commonplace in highest risk women. Consider visit with gynecology (Dr. Pearlman) to discuss risks/benefits/timing of BSO.
Annual mammography (starting age 30), yearly breast MRI (starting age 25), and twice annual breast exams (starting age 21) in BRCA mutation carriers and blood relatives who are untested.
Suggested Additional Test/Management Prior to Specialty Visit
Offer genetic counseling and referral to Dr. Merajver's clinic.
3 generation family history for cancer should be documented.
Written informed consent will need to be documented before genetic testing - MI state law.
If presence of pancreatic cancer in the family history, refer to GI to discuss pancreatic cancer screening options.
Patient Education/Information (includes preps)
Provided at time of visit
If asymptomatic, within 4-6 weeks
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Please fax to 734-763-7672
Clinic Contact Information
Patient: 734-763-6295 (OB/Gyn)
or 734-764-0107 (Breast and Ovarian Cancer Risk Evaluation Program, Kara Milliron, CGC)