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Familial Cancer Risk Assessment Center

Assessment for Cancer Predispositions

The Familial Cancer Risk Assessment Center at Lahey Hospital & Medical Center was created to provide comprehensive risk assessment and management recommendations to individuals with significant personal and/or family histories of cancer.

It is estimated that 1 out of every 3 Americans will develop cancer sometime during their lifetime. While it is difficult to determine the exact cause of cancer in an individual, the majority of cancer is thought to be due to a combination of factors such as chance events, the aging process, or environmental exposures. About 5 to 10 percent of cancer cases are caused by a hereditary predisposition that is passed on within a family.

Inherited factors (genes) play an important role in many cancers. We know of several genes that are associated with an increased chance of developing certain types of cancer, including breast, ovarian, colon, and uterine cancer. Features that are suggestive of a hereditary predisposition to cancer include the following:

  • Multiple family members affected with the same cancer (such as breast cancer) or related cancers (such as breast and ovarian cancer, or colon and uterine cancer)
  • Earlier than average ages of diagnosis
  • Multiple primary cancers in the same individual (such as cancer in both breasts)
  • Cancer occurring in multiple generations

In This Section

Meet the Team

Julie O. Dennis, MD
Julie O. Dennis, MD General Surgery Breast Surgery
Ashling O'Connor, MD
Ashling O'Connor, MD General Surgery Breast Surgery
Lata Chandi Thatai, MD
Lata Chandi Thatai, MD Hematology/Oncology

Genetic Counselors

  • Taryn Rourke
  • Rhonda Feinbaum
  • Punitha Kannan
  • Gabriella Raffaele

When to Refer for Genetic Counseling

The majority of individuals do not have family histories that are suggestive of a hereditary cancer predisposition. The following guidelines may help practitioners and patients determine who should seek cancer genetic counseling services.

There are several features of a family history that should raise the suspicion of a hereditary breast or ovarian cancer syndrome:

  • A personal or family history of early-onset breast cancer (<45)
  • A personal or family history of ovarian cancer at any age
  • A personal history of two or more breast cancers
  • A personal history of breast and ovarian cancer
  • A personal history of breast cancer at any age and at least one close family member with breast or ovarian cancer
  • A family history of two or more close family members with breast or ovarian cancer

There are several features of a family history that should raise the suspicion of a hereditary colon cancer syndrome:

  • A personal or family history of colon cancer diagnosed at an unusually young age (<50 years)
  • A personal or family history of colonic polyps diagnosed at an unusually young age (<45 years) or in large numbers (>10 polyps)
  • The presence of distinctive extra-colonic cancers, such as uterine cancer and colon cancer, in a family

To request an appointment with a genetic counselor in the Familial Cancer Risk Assessment Center, please call 781-744-9229.

Learn More

Counseling & Genetic Testing Services

Cancers that are most commonly associated with a hereditary predisposition include breast and ovarian cancers, colon cancer, and uterine cancer. However, individuals with other types of cancer may also wish to consult with a genetic counselor. There are rare hereditary cancer predisposition syndromes that are associated with other types of cancer, such as thyroid cancer and stomach cancer. A genetic counselor can help evaluate your personal and family history to determine if a risk assessment appointment is necessary.

Please contact us at 781-744-9229.

Our center provides counseling and genetic testing for the following syndromes:

  • Hereditary Breast and Ovarian Cancer syndrome (including the BRCA1 and BRCA2 mutations)
  • Cowden syndrome
  • Li-Fraumeni syndrome
  • Hereditary Non-Polyposis Colorectal Cancer syndrome (Lynch syndrome)
  • Colon polyp syndromes: Familial Adenomatous Polyposis, MYH-Associated Polyposis, Juvenile Polyposis
  • Hereditary Diffuse Gastric Cancer syndrome
  • Peutz-Jeghers syndrome
  • Von Hippel-Lindau syndrome
  • Birt-Hogg-Dube syndrome
  • Hereditary Paraganglioma syndrome
  • Multiple Endocrine Neoplasia, Type 1 and Type 2 syndrome
  • Hereditary Leiomyomatosis and Renal Cell Cancer syndrome
  • Hereditary Papillary Renal Cell Cancer syndrome
  • Familial Atypical Multiple Mole Melanoma syndrome
    Breast & Ovarian Cancer
    Genetic Counseling at the Breast Center

    The Breast Center at Lahey Hospital & Medical Center provides high-quality, comprehensive diagnostic care and treatment for benign (non-cancerous) breast conditions and breast cancer. Learn more about evaluation and screening options for individuals at high risk for breast cancer.

    As part of the Breast Center, genetic counseling is available to individuals with a personal or family history of breast and/or ovarian cancer that is suggestive of a hereditary cancer predisposition. There are several features of a family history that raise the suspicion of a hereditary breast or ovarian cancer syndrome:

    • A personal or family history of early-onset breast cancer (<45 years of age at time of diagnosis)
    • A personal or family history of ovarian cancer at any age
    • A personal history of two or more breast cancers
    • A personal history of breast and ovarian cancer
    • A personal history of breast cancer at any age and at least one close family member with breast or ovarian cancer
    • A family history of two or more close family members with breast or ovarian cancer

    An initial cancer genetic counseling session typically lasts one hour. During this session, a genetic counselor will ask detailed questions about your personal medical history and the medical history of your family members. The family tree (pedigree) is a useful tool for determining the likelihood that the cancer in the family is due to a hereditary cancer predisposition gene. The session will include a discussion of cancer genetics and the purpose of genetic testing, including advantages and disadvantages of pursuing genetic testing. Other topics that are often discussed in the initial session include potential genetic discrimination concerns and current legal protections, risks to other family members and screening recommendations.

    If an individual decides to pursue genetic testing, a genetic counselor will help facilitate the testing. Follow-up appointments are often necessary to discuss the genetic test results and typically last up to 30 minutes. Visit our patient education page to learn about basic genetics principles and for information about specific hereditary cancer predisposition syndromes.

    To schedule an appointment with a genetic counselor, please call 781-744-9229.

    Colon & Rectal Cancer
    Colorectal Cancer Genetic Counseling

    In conjunction with the Department of Colon and Rectal Surgery, genetic counseling is available to those with a personal or family history of colorectal cancer that is suggestive of a hereditary cancer predisposition.

    There are several features of a family history that should raise the suspicion of a hereditary colon cancer syndrome:

    • A personal or family history of colon cancer diagnosed at an unusually young age (<50 years)
    • A personal or family history of colonic polyps diagnosed at an unusually young age (<45 years) or in large numbers (>10 polyps)
    • The presence of distinctive extra-colonic cancers, such as uterine cancer and colon cancer, in a family

    If an individual decides to pursue genetic testing, a genetic counselor will help facilitate the testing. Follow-up appointments are often necessary to discuss the results of the genetic test and typically last up to 30 minutes.

    Visit our patient resources page to learn about basic genetics principles and for information about specific hereditary cancer predisposition syndromes.

    To schedule an appointment with a genetic counselor, please call 781-744-9229.