Computer Solutions to Identify and Manage Women at High Risk

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Presentation transcript:

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

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

HughesRiskApps www.HughesRiskApps.net Kshughes@Partners.org

Demo

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

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

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

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

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

BRCAPRO

Options for high risk

Prophylactic Oophorectomy Options for high risk Chemoprevention Prophylactic Oophorectomy Screening