Dana-Farber Cancer Institute's Center for Cancer Genetics and Prevention includes a team of expert health professionals – medical oncologists, gastroenterologists, geneticists, gynecologists, psychologists, surgeons, nurses, and genetic counselors — who provide cancer risk assessment and comprehensive recommendations for managing cancer risk.
As part of risk assessment, we offer genetic and genomic testing to determine risk for inherited cancer syndromes such as breast and ovarian cancer syndromes (BRCA1 and BRCA2), Lynch Syndrome, and various rare cancer syndromes.
We also conduct research into many aspects of cancer risk and its management.
Dana-Farber Cancer Institute developed one of the first clinical cancer genetics and prevention programs in the world. The program was first developed based on the fundamental work of Dr. Frederick P. Li, one of the founders of the field of cancer genetics and one of the physicians who first recognized Li-Fraumeni syndrome.
Today, we provide expert comprehensive care for cancer patients, survivors and families who have had cancer, for their family members, and for individuals who hope to avoid cancer.
A visit to the Cancer Genetics and Prevention Clinic usually includes time with both a physician and a genetic counselor, both of whom have expertise in all forms of inherited cancer syndromes. We educate patients about cancer risk and its implications for them and their family members. Working with referring physicians, we design individualized programs to monitor for the earliest signs of cancer — diagnosing if it occurs, and, in many cases, preventing it from arising.
If you or your doctor thinks that you are at increased risk of developing cancer or may have an inherited risk of cancer, we can provide an estimate of your risk as accurately as possible, and work with you, and your health care team to provide strategies to help lower your cancer risk.
The landscape of the field of genetics is rapidly changing. We provide advanced options in genetic testing across the spectrum of new and established inherited cancer syndromes. The syndromes include, but are not limited to:
A: Genes are individual units of inheritance made of DNA. We all have two copies of each gene; we inherit one copy from each of our parents and pass one copy on to each child. The exact DNA sequence of a gene is a code with instructions to make a functioning protein (like a recipe). Changes to the DNA code can cause the gene not to work and stop its protein from being made.
A: Genetic testing is a process that looks for alterations in a person's genes. Alterations in certain genes may lead to an increased risk of cancer. Therefore, genetic testing results may be helpful in tailoring cancer screening recommendations.
Genetic testing involves sending a blood sample to a specialized lab for analysis. Results are returned to the ordering physician and genetic counselor, who then discloses them to the patient and arranges appropriate follow-up care.
A: Genetic counselors are trained licensed professionals who have earned a Master's degree in genetic counseling from an accredited program. Cancer genetic counselors specifically counsel patients about inherited cancer syndromes, the chance they might carry a gene in a form that confers increased risk of specific inherited cancer syndromes, the mechanics of genetic testing, the patient's chance of having an inherited susceptibility to cancer, and the implications of being found to carry or not carry a genetic risk for cancer.
The role of a genetic counselor is to assist individuals and families in understanding genetic disorders. Genetic counselors:
Genetic counselors often help to interpret confusing or uncertain test results, and also educate patients and providers on new testing options. For this reason, genetic counselors may maintain contact with patients over time.
A: During the visit, your genetic counselor will take a detailed family history in order to evaluate the likelihood that you could have an inherited predisposition to cancer. Features of a family history that suggest a hereditary susceptibility include:
The genetic counselor may then discuss the option of testing and will explain the relevant gene(s) and associated syndrome in terms of cancer risks and medical management issues. Common concerns of genetic testing, including issues of insurance discrimination and confidentiality, will be discussed. Possible results of genetic testing, as well as the cost and logistics of testing, insurance coverage, or options if insurance does not cover, will also be reviewed. Your genetic counselor will help to guide you in making the best decisions regarding genetic testing for yourself, as a decision to undergo genetic testing or not is truly a personal decision.
A: Information regarding personal and family cancer history – including the specific cancer(s), age(s) at diagnosis or information about pre-cancerous conditions such as colon polyps – and copies of personal or family genetic test results are requested for your visit. Other medical records such as pathology reports, surgical reports, or summary notes) are often useful. Also helpful are prior pathology reports.
A: We recommend general guidelines for a healthy lifestyle as endorsed by the American Cancer Society and the National Cancer Institute, as these may also help reduce your risk for developing cancer.
Genetic and genomic testing enables the examination of DNA and assists in determining susceptibility to inherited diseases. Genetic testing for cancer predisposition has traditionally been done by looking at one gene at a time. With advances in technology, multiple genes can be evaluated in parallel through one test — this is referred to as panel testing or multiplex testing. New technologies such as whole genome or exome testing (evaluation of the complete set of DNA) of a person or a tumor may identify a hereditary cancer predisposition.
Some of the testing capabilities at Dana-Farber Cancer Institute include:
Screening procedures that we would be happy to assist in scheduling at Dana-Farber Cancer Institute or Brigham and Women's Hospital include:
Below is a list of our current genetic trials and studies:
While most genetic disorders cannot be cured, genetic research has provided – and continues to provide – new and improved treatments for individuals found to have genetic mutations associated with disease. Through continued research, doctors and scientists hope to provide more personalized disease treatments, while improving the speed and accuracy of genetic testing.
Progress in the identification of cancer genes and genetic syndromes, and in the management of individuals who have increased cancer risk, all comes from cancer research. Participation in clinical trials provides individuals with an opportunity to volunteer to become part of genetic research in a meaningful way. For those who elect to take part, clinical trials may provide access to new drugs and treatments, as well as closer monitoring by health care professionals.
For more information about our research studies, contact:
Carleen Gentry, MA, CCRPResearch Project Managercarleen_gentry@dfci.harvard.edu
Chinedu Ukaegbu, MBBS, MPHResearch Project ManagerchineduI_ukaegbu@dfci.harvard.edu
Dana-Farber Cancer Institute's Center for Cancer Genetics and Prevention offers a unique team approach to genetic testing and cancer risk management. We provide an initial cancer risk evaluation with an experienced genetic counselor and physician to discuss your personal and family history. Our team is available to talk with you and your family members. One goal of this evaluation is to help you learn what steps you can take to lower your cancer risk.
Judy E. Garber, MD, MPH, Director, Center for Cancer Genetics and Prevention (medical oncologist)Sapna Syngal, MD, MPH, Director, Gastrointestinal Cancer Genetics and Prevention Clinic (gastroenterologist)Huma Q. Rana, MD, Clinical Director, Center for Cancer Genetics and Prevention (geneticist)Daniel Cramer, MD, ScD (gynecologist)Joel Goldberg, MD (colorectal surgeon)Ramona Lim, MD (gastroenterologist)Daniel Morganstern, MD (medical oncologist)Beth Overmoyer, MD (medical oncologist)Rochelle Scheib, MD (medical oncologist)Daniel Silver, MD, PhD (medical oncologist)Matthew Yurgelun, MD (medical oncologist)
Andrea Farkas Patenaude, PhD (clinical psychologist)
Rhonda Grealish, RN, BSNMargaret Klehm, RN, MPH, MSN, FNPHolly O'Kane, RN, NP
Anu Chittenden, MS, LGCClaire Healy, MS, LGCCarmelina Heydrich, MS, LGCElaine Hiller, MS, LGCShelley McCormick, MS, LGCIrene Rainville, PhD, LGCJaclyn Schienda, MS, LGCKatherine Schneider, MPH, LGCJilliane Sotelo, MS, LGC
Victoriana Curry, BA, Clinical Research Coordinatorvictorianak_curry@dfci.harvard.edu
Lisa DiGianni, PhD, Senior Research Scientistlisa_digianni@dfci.harvard.edu
Carleen Gentry, MA, CCRP, Research Project Managercarleen_gentry@dfci.harvard.edu
Maja Krsmanovic, BS, Clinical Research Coordinatormaja_krsmanovic@dfci.harvard.edu
Alexandra Paulo, BS, Clinical Research Coordinatoralexandra_paulo@dfci.harvard.edu
Elizabeth J. Root, BS, Research Project Managerelizabeth_root@dfci.harvard.edu
Margery Rosenblatt, MA, Research Project Managermargery_rosenblatt@dfci.harvard.edu
Chinedu Ukaegbu, MBBS, MPH, Research Project ManagerchineduI_ukaegbu@dfci.harvard.edu
Please contact us with any questions or inquiries:
Dana-Farber Cancer InstituteCenter for Cancer Genetics and Prevention450 Brookline AvenueMS 1068Boston, MA 02215
Hannah Green, MPH, Manager, Disease Center Operationshannah_green@dfci.harvard.edu617-632-2359
Carleen Gentry, MA, CCRP, Research Project Managercarleen_gentry@dfci.harvard.edu617-632-5399
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