Features
- Cover Type: Paperback with 417 pages
- Published by: Cambridge University Press
- Edition: 1st Edition July 21, 2005
- Written in: English
- ISBN 10 Number: 0521017777
- ISBN 13 Number: 978-0521017770
-
Book Dimensions:
9.5 x 6.7 x 0.9 inches
- Weighs: 1.4 pounds
From The New England Journal of Medicine
The explosion in knowledge of cancer genetics during the past decade has led to the availability of abundant information about the incidence of cancer-causing mutations, disease penetrance, and risk-reduction strategies. The application of this information to clinical practice is enormously challenging because of the lack of prospective, randomized trials and the inherent individual variability of preferences regarding ways of reducing risk. The attitudes of patients toward genetic testing for mutations that cause cancer add to the complexity of decisions about the appropriate use of the results of such tests by physicians. Until we find acceptable alternatives to prophylactic surgery, ignorance remains blissful for some people who have a clinically significant family history of cancer. Familial Breast and Ovarian Cancer is an great introduction to the genetics of breast and ovarian cancer. The book is a collection of chapters by investigators in clinical, epidemiologic, and molecular science from Europe and Canada, with substantial contributions from researchers in the United Kingdom. The first section of the book focuses on the molecular biology and natural history of hereditary breast and ovarian cancer. These first eight chapters are wonderfully written and provide basic and in-depth information on the genetics of inherited breast and ovarian cancer syndromes. A minor criticism is that these chapters lack photographs demonstrating the physical features of Peutz-Jeghers syndrome and Cowden's disease -- infrequent cancer syndromes associated with a high prevalence of breast and ovarian cancer. The authors of these chapters thoughtfully and concisely consider the limitations of studies evaluating survival and estimations of risk. The discussion of the application of risk-estimation models will be extremely helpful for physicians who care for women at high risk. The second part of the book will be of interest primarily to medical communities that are building the infrastructure for a cancer-genetics service. Although the approaches discussed are biased toward a United Kingdom perspective in terms of the development of a cancer-genetics service based on geographic communities, conventions in other countries are noted. A discussion of specific cases and of approaches to triage for patients in the community would have strengthened these chapters. Finally, the book turns to the care of women who are at high genetic risk for inherited breast or ovarian cancer. A comprehensive overview of prevention studies involving the use of tamoxifen, prophylactic mastectomy, and oophorectomy is presented, although more consideration is given to the treatment of existing cancers than to the prevention of cancer in asymptomatic women. A more thorough discussion of investigative screening tools such as magnetic resonance imaging and proteomics would have complemented the discussion of current management protocols. The aim of a cancer-genetics program should be to provide a service to the community, but it is perhaps more important that such a program develop interventions for early detection and prevention that decrease mortality and prevent patients from facing the challenging and emotionally difficult choices regarding prophylactic surgery. Most chapters contain tables with summaries of published studies that can serve as a comprehensive reference. Despite minor shortcomings, these chapters touch on important controversies regarding management and provide a framework for physician-patient discussions of these issues. Each chapter provides a complete review of the literature to the year 2000. The challenge in writing a review book on this topic is that the field of cancer genetics is dynamic, and new data are constantly being introduced that modify our current views about the penetrance of mutations and risk management. Since 2000, more than 500 articles have been published in English about BRCA1 and BRCA2, the breast-cancer-susceptibility genes responsible for seventy percent of inherited breast cancers. New and conflicting results are published weekly regarding the effects of such interventions as prophylactic oophorectomy and the use of oral contraceptives. The challenge in this era of genomic medicine is to use a person's genetic information constructively to provide the most benefit to the patient while conferring the least harm. This book successfully serves a number of purposes: it presents a thorough review of the genetics of inherited breast and ovarian cancer for family care physicians, gynecologists, general surgeons, and oncologists; it is useful to practitioners in areas in which a formal cancer-genetics program has not been established; and it offers a discussion of the care of patients with inherited risk factors. Overall, this book serves as a practical and comprehensive resource for a range of health care providers in the field of cancer genetics.
Anne-Renee Hartman, M.D.Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
--This text refers to the
Hardcover
edition.
Product Review
"This text book is a timely publication and it gives a splendid overview of the genetics and management of familial breast and ovarian cancerpractical, up to date and well referencedColleagues throughout the profession from a wide range of disciplines will find much in this book to interest them and will help them guide and manage their patients through the difficult decision journey of familial cancer." Ulster Medical Journal
"a very good state-of-the-art document of the current knowledge, covering most aspects of the genetic background and the clinical management of suspected familial breast and ovarian cancerrecommended for newcomers to the field of cancer genetics, and for those interested clinicians and policymakers who need a comprehensive base for maintaining and developing a clinical service." Hum Genet
"Over all, the text is very readable for a general scientific audience.This edited text covers all of the major areas of interest in considering familial and hereditary breast and ovarian cancers. Although the editors, most authors, and the focus on services are European, there are enough commonalities to make the book a worthwhile purchase for North American readers as well." American Journal of Human Genetics
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