No one can exactly predict whether or not you will develop cancer. But there are factors that may put you at a higher risk. Determining your personal cancer risk may create an opportunity for prevention, early detection or more effective treatment.
At Penn Medicine’s Mariann and Robert MacDonald Cancer Risk Evaluation Center, we understand the implications of cancer risk for you and your entire family. As one of the nation's largest genetics programs, we help you identify, understand and manage your chance of developing cancer.
The Marian and Robert MacDonald Cancer Risk Evaluation Center sees patients at various locations, including Penn Medicine Princeton Cancer Center. As part of one of the first programs in the country to offer comprehensive evaluation and testing for a wide variety of hereditary conditions including breast and ovarian cancers. At the Center, you'll find:
- High-level expertise: You'll work with our nationally recognized experts who have years of experience in breast and ovarian cancer risk. We streamline the process of genetic testing and deliver education, guidance and support specific to your cancer risk.
- Collaborative care: Our genetic counselors work hand-in-hand with your oncology providers.
- Personalized risk management: Using advanced technology we evaluate your family health history for inherited risk syndromes. We partner with you to develop a lifetime plan that includes medical recommendations, risk reduction strategies and proactive long-term follow-up care.
- Dedicated resources for BRCA-related cancers: If you test positive for either a BRCA1 or BRCA2 gene mutation, the genetic councilors will work with your treatment team at Penn Medicine Princeton Health to determine appropriate follow up care.
- Access to research opportunities: We offer access to novel clinical trials focused on cancer risk including novel screening trials, individualized risk modifications and therapies for specific gene mutations.
How We Manage Cancer Risk
Our evaluation considers both lifestyle and inherited cancer risk. We analyze your medical, personal and family history using advanced diagnostic technology and when appropriate, we offer genetic testing. We also review outside genetic test results if you've already been tested.
If we establish that you are at a high risk for breast cancer, we offer:
- Tailored medical recommendations
- Coordinated screening and long-term follow-up care
- Opportunities to participate in innovative research studies
- Education programs about the role of genetics in your disease
- Support services, including cancer counselors
Understanding Hereditary Cancer
Hereditary cancer occurs when a change in a specific gene (known as a pathogenic variant or mutation) is passed from generation to generation within a family. Inheriting this specific gene mutation causes an increased risk for certain types of cancer. About 5 to 10 percent of cancers are caused by an inherited gene mutation. In contrast, most cancers are "sporadic", meaning that they are random or caused by environmental factors, like age, smoking or obesity.
For example, the two genes most often linked to hereditary breast and ovarian cancer are BRCA1 and BRCA2. Mutations in BRCA1 and BRCA2 make you more likely to develop breast and ovarian cancer. About 5 to 10 percent of diagnosed breast cancers and 20 to 25 percent of diagnosed ovarian cancers are due to inherited genetic susceptibility. Other genes are also associated with an increased risk of breast, ovarian and other cancers. The blood or saliva tests we use to identify BRCA1 and BRCA2 mutations can check for many of these other genes at the same time.
Who Should Consider Genetic Testing
Our specially trained genetic counselor helps you or your family determine if you are a candidate for testing. We conduct a genetic risk evaluation with or without a cancer diagnosis. If you've already been diagnosed with cancer, genetic testing establishes whether you have an increased risk of developing a second cancer.
Consider genetic testing if you or a family member has had:
- Breast or colon cancer at age 50 or younger
- Triple negative breast cancer at any age
- Ovarian, fallopian tube cancer, or pancreatic cancer any age
- Metastatic or high-risk prostate cancer at any age
- A single individual diagnosed with more than one breast cancer diagnosis
- Male breast cancer
- Breast or prostate cancer at any age and of Ashkenazi Jewish ancestry
- A known pathogenic variant (mutation) in a cancer risk gene (e.g., ATM, BRCA1, BRCA2, BRIP1, CHEK2, PALB2, RAD51C, RAD51D, TP53)
- Family history of breast, ovarian, pancreatic or high-grade prostate cancer diagnosed in multiple individuals on the same side of the family
Request an Appointment
To make an appointment with a genetic counselor at Penn Medicine Princeton Cancer Center contact the MacDonald Cancer Risk Evaluation Center at 215.349.9093 or email CREPteam@pennmedicine.upenn.edu.
How much does the genetic consultation cost?
The consult is billed to a patient’s insurance and is considered a specialist visit. If you have a co-pay, it will be collected at the time of your visit. Patients are advised to check with their insurance to see if their plan is in network AND if a referral to see a specialist is needed. If a referral is needed, the scheduling team can provide you with the necessary provider NPI number and information. Certain insurance plans require genetic consultation with a qualified provider prior to authorizing genetic testing. Two current examples are AETNA and United Healthcare (UHC).
How much does genetic testing cost?
For most patients, the out of pocket cost for genetic testing is minimal. In many cases, health insurance plans will cover part or all of the costs of genetic testing if they meet certain criteria. The cost of genetic testing can vary depending on the nature and complexity of the test selected. The genetic counselor will answer specific billing and cost questions during a patient’s appointment and can provide the billing policy for their individual test.