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Computer Solutions to Identify and Manage Women at High Risk

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Presentation on theme: "Computer Solutions to Identify and Manage Women at High Risk"— Presentation transcript:

1 Computer Solutions to Identify and Manage Women at High Risk
Kevin S.Hughes, MD, FACS Co-Director, Avon Comprehensive Breast Evaluation Center Massachusetts General Hospital Surgeon The Newton-Wellesley Hospital Breast Center

2 EHR EHR Patient enters data : Tablet PC iPad Website
Patient educational materials Clinical Decision Support EHR Reviews Report Reviews suggested Management Adds clinical information Clinical Decision Support Documents and Orders EHR

3 HughesRiskApps

4 Demo

5 Our Goal Find every mutation carrier for every hereditary syndrome known to man before disease occurs

6 Cancer Risk BRCA1 BRCA2 Breast 63% 55% Ovary 58% 30% Breast 6% BRCAPRO
F e m a l M Breast 63% % Ovary % 30% Breast % BRCAPRO

7 BRCA1/2 Mutation carriers in the US
Jewish (1/40) 6,191,281 154,782 Not Jewish (1/350) 275,230,624 786,373 281,421,906 941,155 ~1,000,000 carriers ~350,000 females 20 and older

8 15 years of genetic testing
BRCA tests to date ~500,000 Assume 10% positive 50,000 BRCA1/2 carriers found Assume most tested patients had cancer 95 to 99% of unaffected carriers not tested Likely the best of any adult hereditary syndrome

9 Family history Multiple relatives affected Young age at diagnosis
Multiple primary cancers Unusual Cancer Male breast cancer

10 BRCAPRO

11 Options for high risk

12 Prophylactic Oophorectomy
Options for high risk Chemoprevention Prophylactic Oophorectomy Screening

13


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