Understanding hereditary breast and ovarian cancer.

Digital Object Identifier: 10.1188/03.CJON.591-594 In 1994, the first cancer susceptibility gene to be associated with hereditary breast and ovarian cancer was identified and became known as breast cancer gene 1 (BRCA1). In 1995, a second gene was identified and became known as BRCA2 (Calus, Schildkraut, Thompson, & Risch, 1996). With the identification of these two genes, a new field emerged in breast and ovarian cancer treatment that is transforming how a select population of people with these cancers is managed. However, the identification of these cancer susceptibility genes also has prompted new challenges and concerns, including identifying patients who are appropriate for genetic testing, informing patients about the advantages and disadvantages of genetic testing, and determining the appropriate treatment for those who test positive for a genetic mutation (alteration). In addition, ethical, legal, and psychosocial implications for patients and their families exist. As knowledge of cancer genetics has increased, so has awareness of cancer genetics among healthcare professionals and the public. Oncology nurses can be instrumental in informing patients, families, and the public about the implications of these findings in terms of cancer prevention, early detection, and treatment. In addition, knowledge in this area has become essential to healthcare professionals when obtaining family histories to help identify patients who may have hereditary cancers. Recognizing the importance of this area in oncology nursing, the Oncology Nursing Society (ONS) has developed position statements regarding cancer predisposition genetic testing and risk assessment counseling and the role of oncology nurses in cancer genetic counseling. ONS stated that oncology nurses at the general and advanced practice levels must be educated in genetic testing and counseling and continuing education programs should be developed and provided to practicing oncology nurses. In addition, advanced practice nurses with specialized training in cancer genetics should provide comprehensive cancer genetic counseling (ONS, 2002a, 2002b).