BS20 FAMILIAL GYNAECOLOGICAL CANCER – ASPECTS OF CLINICAL MANAGEMENT

There are significant familial associations between surgical and gynaecological cancers. hereditary non polyposis coli cancer was first described as a family with an increased risk of gynaecological cancer and BRCA mutations have a well known association with ovarian as well as breast cancer. To complicate issues colorectal and breast cancer share similar etiologic factors to colorectal and breast cancers and treatments may influence the incidence and treatment of these cancers. This talk will discuss issues related to; the identification of familial cancer syndromes, screening and prophylactic treatment in women with familial cancer syndromes, quality of life and hormone replacement therapy. The following issues are considered relevant: Women with breast cancer and people under 50 with colorectal cancer or should have family histories taken and genetic counseling referrals made where appropriate. Women with HNPCC related or BRCA mutations should be counseled by a gynaecologist with expertise in familial cancer. Women with BRCA mutations probably do not benefit from screening. Prophylactic surgery is normally indicated. Women with HNPCC should be counseled regarding their risk of gynecological cancer risk reducing surgery is sometimes indicated. Menopause caused by oophorectomy, radiotherapy or chemotherapy is associated with a significant reduction in quality of life. Hormone replacement therapy should be considered.