Jubilee Brown, MD

Jubilee Brown, MD, professor of gynecologic oncology, associate director of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, discusses germline and somatic testing in ovarian cancer.

Germline testing may identify inherited mutations such as 

, explains Brown. Testing may also reveal rarer mutations that confer increased risk of other cancers and the need for surveillance.

Family members of patients with inherited mutations should also be considered for germline testing to potentially prevent future cancers.

Somatic testing can identify a wider range of mutations compared with germline testing. These mutations, which occur within the tumor, may be less common that germline mutations, says Brown.

Rare ovarian cancers may harbor actionable germline or somatic mutations that can be targeted with therapy, concludes Brown.

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Jubilee Brown, MD, discusses germline and somatic testing in ovarian cancer.

Dr. Brown on Germline and Somatic Testing in Ovarian Cancer

Jubilee Brown, MD, professor of gynecologic oncology, Levine Cancer Institute, Atrium Health, discusses the importance of genetic testing in patients with ovarian cancer.

There are a number of reasons why genetic testing could have an impact on patient outcomes. First, by detecting women with hereditary mutations, clinicians can identify those who are at risk for ovarian cancer and intervene before they ever get the disease. There is approximately a 95% reduction in risk if these patients are identified, Brown says. The other key component is that in patients who have ovarian cancer, genetic testing can help decide if their family members are also at risk. Additionally, if a patient’s mutation profile is identified, it helps the process of deciding which targeted therapy to use.

The implementation of PARP inhibitors in ovarian cancer has greatly improved outcomes for patients with BRCA mutations, Brown says.

Jubilee Brown, MD, professor of gynecologic oncology, Levine Cancer Institute, Carolinas HealthCare System, discusses the importance of genetic testing in patients with ovarian cancer.

Dr. Brown on the Importance of Genetic Testing in Ovarian Cancer

Jubilee Brown, MD, professor of gynecologic oncology, Levine Cancer Institute, Carolinas HealthCare System, discusses the adoption of genetic testing into routine clinical practice.

The adoption of genetic testing has become more widespread, says Brown, but not widespread enough. In 2014, the Society of Gynecologic Oncology released guidelines stating that all women with ovarian cancer should undergo genetic testing. In addition to these guidelines, Brown says that the media has helped significantly in bringing genetic testing to the forefront of the conversation. An example of this would be when Angelina Jolie came forward saying that she had testing. This caused a big uptake, says Brown.

Additionally, there are references to testing in the mainstream press, explains Brown. If someone picks up a magazine in a grocery store, they are likely to read about genetic testing. The goal now, says Brown, is to continue to educate people who should be tested, and dispel common misconceptions. Within the medical community, Brown says family practice doctors and internists also need to be educated on testing, as they are the physicians who are the most likely to encounter the people who stand to benefit the most from testing.

Dr. Brown on the Adoption of Genetic Testing

Jubilee Brown, MD, obstetrician-gynecologist, Levine Cancer Institute, Carolinas HealthCare System, discusses genetic counseling for patients with breast and ovarian cancer. 

With a multi-pronged approach that included physician and provider engagement and education, patient navigation, genetic counseling services, and telegenetics, there was an increase in the number of patients who were referred with ovarian cancer from 37% to 96% within a 2-year period. 

This was then able to be reproduced for patients with breast cancer. Additionally, there was an increase in patients who were tested from 24% to over 50% in the same 2-year period, explains Brown.

Jubilee Brown, MD, obstetrician-gynecologist, Levine Cancer Institute, Carolinas HealthCare System, discusses genetic counseling for patients with breast and ovarian cancer.

Author | Jubilee Brown, MD

Articles

Dr. Brown on Germline and Somatic Testing in Ovarian Cancer

Dr. Brown on the Importance of Genetic Testing in Ovarian Cancer

Dr. Brown on the Adoption of Genetic Testing

Dr. Brown on Genetic Counseling for Breast and Ovarian Cancer