Guidelines for complex genetic analysis of hereditary breast ovarian cancer syndrome in slovak population

M. Konečný, I. Mlkva, J. Simko, L. Copáková, L. Kádasi, F. Cisárik, L. Dolesova, K. Závodná, J. Markus
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Abstract

Abstract Genetic diagnostics of hereditary breast and ovarian cancer (HBOC) has been performed in Slovakia in many different forms before the year 2000. Complex HBOC genetic analysis consists of many steps, including the initial genetic consultation, laboratory testing of genes associated with HBOC, interpretation and report of DNA analysis results, secondary explanatory genetic consultation and recommendation of clinical management for pathological mutation carriers. Many clinicians are participating on this workflow, such as clinical geneticists, laboratory diagnosticians as well as gynaecologists, oncologists or radio-diagnosticians. Currently, genetic testing is still technically and financially demanding and aimed only at selected families or patients who fulfil the defined clinical indication criteria. Positive result of DNA analysis, that is, detection of pathological mutation in genes associated with HBOC syndrome means that the risk of breast/ovarian cancer onset in mutation carriers is amplified. This predisposition markedly affects the clinical management and treatment of patient and other members of the family, thus creating the demand to establish widely accepted specific recommendations for genetic diagnostics of HBOC. In the past, the analysis of HBOC in Slovakia followed various technical approaches and indication criteria depending on the workflow of specific laboratory. The guidelines reported below adhere to the current trends in DNA analysis and clinical healthcare, define the criteria for diagnostic laboratories, conditions for genetic testing and determine indications for selection of HBOC families and further clinical management of mutation carriers.
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斯洛伐克人群遗传性乳腺癌综合征复杂遗传分析指南
在2000年之前,斯洛伐克以许多不同的形式进行了遗传性乳腺癌和卵巢癌(HBOC)的遗传诊断。复杂的HBOC遗传分析包括初始遗传咨询、HBOC相关基因的实验室检测、DNA分析结果的解释和报告、二次解释性遗传咨询和病理突变携带者的临床管理建议等多个步骤。许多临床医生都参与了这一工作流程,如临床遗传学家、实验室诊断医生以及妇科医生、肿瘤学家或放射诊断医生。目前,基因检测在技术上和经济上仍然要求很高,而且只针对符合明确临床指征标准的选定家庭或患者。DNA分析阳性,即检测到HBOC综合征相关基因的病理突变,意味着突变携带者发生乳腺癌/卵巢癌的风险增大。这种易感性显著影响患者和其他家庭成员的临床管理和治疗,因此需要建立广泛接受的HBOC遗传诊断的具体建议。过去,斯洛伐克的HBOC分析根据特定实验室的工作流程采用各种技术方法和指示标准。以下报告的指南遵循了DNA分析和临床保健的当前趋势,定义了诊断实验室的标准、基因检测的条件,并确定了选择HBOC家族和进一步临床管理突变携带者的适应症。
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