Practical aspects of genetic counseling in breast cancer: Lights and shadows

Abstract In unselected populations, less than 10% of breast cancers are associated with germline mutationsin predisposing genes. Breast cancer type 1 and 2 ( BRCA1 and BRCA2 ) susceptibility genes are the most common involved genes and confer a 10–30 timeshigher riskof developing the disease compared to the general population. A personal or family history suggestive of inherited breast cancer syndromemay be further evaluated to assess the risk of genetic predispositionand the presence of a genetic mutation. Breast cancer genetic counselingshould include a careful risk assessment with associated psychosocial evaluation and support, possible molecular testing, personalized discussion of results. Knowledge of BRCA status can influence individualized cancer risk- reduction strategies. i.e. active surveillance, prophylactic surgery and/or pharmacoprevention.