Ms. Li is 53 years old and was diagnosed with “triple-negative breast cancer” last year. In addition to her in the family, her mother suffered from colorectal cancer and the previous generation also suffered from breast cancer. I was worried about whether my 20-year-old daughter would have a higher risk of cancer, and triple-negative breast cancer is more malignant, so I decided to perform a genetic test to find out whether he has cancer-related genetic mutations. Fortunately, the test results found that he did not carry the relevant genetic mutation. Ms. Li and her daughter breathed a sigh of relief and felt relieved when they heard the results.
In 2018, there were 34,028 new cancer cases in Hong Kong. Among adults aged 20-59, the proportion of women suffering from cancer is higher than that of men of the same age, mainly due to the relatively higher incidence of gender-related cancers in women such as breast, cervical, uterine body and ovarian cancer. With the current cancer trend and changes in the population structure of Hong Kong, it is expected that the number of new cancers in women will surpass that of men in three years.
Breast cancer has a higher genetic risk
Dr. Wu Yunying, a clinical oncology specialist, explained that at present, the medical profession has confirmed that genetic-related cancers are divided into two categories. One is “hereditary cancer”, which occurs in a small number of families, and because of inherited a specific gene mutation, there is a high incidence of cancer. Risk, and may be passed on to the next generation; the second type is “familial cancer”, that is, more than one family member suffers from one or more cancers, not caused by a single gene mutation currently known, but may be due to multiple This is formed by the interaction of genetic inheritance and acquired environmental factors.
Dr. Wu Yunying pointed out that cancers with higher genetic risk include breast cancer, ovarian cancer, uterine body cancer, colorectal cancer, and prostate cancer. For people with the above cancer risk factors, one of the current considerations is to carry out “cancer risk genetic testing”. The purpose is to know whether they have hereditary cancer genes in order to assess the risk of cancer, which will help prevent, screen and formulate early. Follow up the monitoring plan. “At present, the medical profession only recommends cancer genetic testing for high-risk cancer patients and family members who have been tested for cancer with genetic mutations. Other ordinary citizens who are not cancer or have no family history should not blindly undergo genetic testing.”
Take breast cancer as an example. According to the latest NCCN Oncology Clinical Practice Guidelines, when a breast cancer patient has the following signals, it is recommended to undergo genetic testing:
• Known homologous blood relatives with specific genetic mutations
• Individuals or families with ovarian cancer
• People with bilateral breast cancer
• Early-onset breast cancer (less than or equal to 45 years old at the time of onset)
• Triple-negative breast cancer and younger than 60 years old at the time of onset
• 46-50 years old diagnosed with breast cancer and one or more close relatives with breast cancer, ovarian cancer, pancreatic cancer or prostate cancer
• Has been diagnosed with breast cancer for the second time
• People with pancreatic cancer in family history
• There are three breast cancer patients in the family (including the patient himself)
• People who meet the above conditions have received single gene testing (such as BRCA1/2) but no pathogenic gene mutations have been found
The rapid development of genetic testing technology
Dr. Su Hanhui, an expert in genetics and molecular diagnostics of New Asia Life Technology, pointed out that genetic cancer genetic testing has become very common, and only a few milliliters of blood can be drawn. “However, some local genetic testing companies claim that they can detect more than 500 cancer-related genes. This is really unnecessary. As a result, subjects may find a large number of mutations that do not have any significant medical significance, adding unnecessary Psychological burden. The correct method should be experts in genetics and genetic testing technology, and genetic counselors will assist in the correct selection of genetic testing and genetic risk assessment.”
Although genetic inheritance is an important factor in the development of cancer, acquired prevention cannot be ignored. Carrying hereditary cancer genes does not necessarily lead to cancer. The most important thing is to let yourself and your family understand your physical condition as early as possible, and take preventive measures as early as possible, such as changes in living habits, continuous monitoring, inspections and even treatment to reduce The occurrence of advanced cancer and the reduction of cancer-related mortality.
