March 13th, 2017

Breast Cancer Screening During Pregnancy and Breastfeeding

Screening recommendations for women with BRCA1 and BRCA2 mutations involve annual Breast MRI’s beginning at age 25, paired with annual mammograms beginning at age 30. The average age of childbearing in the United States is 28. Breast cancer screening for high-risk women may be interrupted due to pregnancy and breastfeeding due to the potential risks of breast imaging for pregnant women. Women with a high-risk mutation may find it difficult to know how to stay on top of their screening while considering pregnancy. A recent article titled

"Breast cancer screening of pregnant and breastfeeding women with BRCA mutations" extrapolates information from the current literature to form recommendations regarding when screening is warranted during pregnancy and breastfeeding, and what screening methods are most appropriate during this time.

Before Pregnancy: Before pregnancy, it is important that breast cancer screening is as up-to-date as possible. If a woman is not using contraceptives, pregnancy status should be determined before breast imaging is completed. If a women is planning on becoming pregnant quickly following a previous pregnancy, she is recommended to receive both a Breast MRI and mammogram in between the two pregnancies.

Pregnancy: Throughout the course of a pregnancy, breast awareness and a Clinical Breast Exam (CBE) every 6 months are recommended. If a women has a positive result via a CBE, mammogram or Breast MRI is recommended. While breast imaging may have a risk to pregnant women, if these is concern for breast cancer during pregnancy mammograms or breast ultrasound should be considered.

Breastfeeding: Throughout the course of a breastfeeding, breast awareness and a Clinical Breast Exam (CBE) every 6 months are recommended. If a women has never had breast imaging or is outside the recommended screening interval, and is planning on breastfeeding for an extended period of time, Breast MRI is recommended.

This is a summary on the paper Breast cancer screening of pregnant and breastfeeding women with BRCA mutations Carmichael et al., 2017 .


January 30th, 2017

What I wish I’d known before surgery: BRCA carriers’ perspectives after bilateral salipingo-oophorectomy

A recent article titled,"What I wish I'd known before surgery: BRCA carriers' perspectives after bilateral salipingo-oophorectomy,"  surveyed a group of women who were positive for a BRCA1 or BRCA 2 gene mutation and were undergoing risk reducing surgery to remove their ovaries, fallopian tubes and uterus. The survey asked women about their experience going through surgical menopause and things they wish they would have known before they had is preventative surgery. Below is a list of topics the participants wish they would have known before having the surgery:

1 59% said they would have like to know the impact of this surgery on their sex life,

2. 57% felt it would have helpful to know about the availability of sex counseling

3. 57% said they would have wanted to know more about the risk of coronary heart disease.

To read the article's full abstract please click here:

Have you had a risk reducing bilateral salpingo-oophectomy and hysterectomy (TAH/BSO)? Is there something that you wish your doctor would have told you about before the surgery? Please share below to help us better educate providers and doctors about the topics and guidance needed from women undergoing a TAH/BSO.

December 9th, 2016

BRCA Status Does Not Predict Survival for Young Patients With Breast Cancer

maxresdefaultAccording to a study recently presented at the 2016 San Antonio Breast Symposium, BRCA1 and BRCA2  genetic status does not predict survival rates in young women with breast cancer. “There is no significant difference in survival between BRCA gene carriers and non-carriers amongst all young breast cancer patients,” reported Diana Eccles, MD, of the University of Southampton, United Kingdom. The study did find a difference in survival rates between women who have a triple negative breast tumor with and without a BRCA 1 or BRCA2 gene mutation. Women who have a triple negative breast tumor and a BRCA gene mutation had a better survival rate (11%) than those women who had a triple negative breast tumor and no BRCA gene mutation. The average age for the women in the study were 36 years old.

To learn more about the study please click on this link. 


December 9th, 2016

PALB2 Research Study: Determining Best Treatment For Breast Cancer in PALB2 Carriers


What the study is about: A large research study is currently recruiting females who carry a mutation in their PALB2 gene. Those with a mutation in their PALB2 gene have an increased risk for developing pancreas and breast cancer in their lifetime. The researcher's mission is to determine the best treatment for women with a PALB2 mutation and breast cancer. Through a better understanding, we can personalize breast cancer treatment to increase survival, and determine how to best manage at risk family members to detect cancer early or prevent it.

Who is eligible: Women with a PALB2 mutation who have been diagnosed with breast cancer.

Learn more: To learn more about the study and how to participate please click on the link below. 


September 29th, 2016

Taste for the Cure: A Taste of Science and Breast Health

After nearly 30 years at UCSF, nurse coordinator Debby Hamolsky is leaving us for her next adventure. Please join the UCSF Carol Franc Buck Breast Care Center in honoring her legacy with a day exploring food, science, and breast health.

In the spirit of Debby’s decades of commitment to emotional and educational support for women with breast cancer, our panel topics will focus on personalized screening and treatment and living well during and after cancer. Between panels, join us for science demonstrations, healthy food tastings, and updates on trials and programs available through the Breast Care Center. This educational event is free and open to all.”

To learn more and register click on the link below:

September 22nd, 2016

September 2016 NCCN Guidelines Give Gene Screening Recommendations

The National Comprehensive Cancer Network (NCCN) releases guidelines for physicians and providers to refer to with diagnosis and treating cancer. They also have  section dedicated to hereditary cancer syndromes. Recently, NCCN released it's newest version of NCCN Guidelines which included breast and ovarian cancer management based on a person's genetic test results. Below you will find a number of genes associated with breast and ovarian cancer and the NCCN's recommendations for when and how to screen for and prevent breast and ovarian cancers.












September 14th, 2016

Introducing the PHACT Study: Population Health and Cancer Testing in Bay Area

There are a percentage of individuals in the San Francisco Bay Area who may be carrying disease-causing mutations in their phact_200pxgenes that increase their risk of developing breast, ovarian, pancreatic, prostate or skin cancers. The UCSF Center for BRCA Research believes that these individuals are being missed by the national and insurance-set guidelines created to identify those in need for hereditary cancer screening. Population-based testing will allow us to identify and better serve individuals and their family members who are at risk for hereditary cancer.

By participating in the UCSF Population Health and Cancer Testing (PHACT) study you will be provided with a free saliva collection kit donated by Color Genomics, a genetic laboratory. Thirty genes will be analyzed, including BRCA1 and BRCA2, to identify mutations that increase the chance of cancer in both men and women and genetic counseling support will be available with every test.

If you are interested in participating in this study please email

Eligibility criteria (participant must meet ALL criteria below):

  1. You are 21 years old or older
  2. You can speak and read in English
  3. You live in one of the 9 Bay Area counties (Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma)
  4. You have not had a bone marrow transplant
  5. You have not had a blood transfusion in the last 7 days
  6. You are not receiving treatment for a blood cancer such as leukemia, lymphoma, or multiple myeloma

*Participants must also have a working email address

August 9th, 2016

New MisMatch Repair Gene (MSH3) Found to Cause Colorectal Polyposis and Cancer

A recent study found that mutations mismatch repair gene, MSH3, have been found to cause colon polyps and colon cancer. maxresdefaultResearchers found that if someone inherits 2 mutations in their MSH3 gene they will have an increased risk for developing 10's-100's colon polyps, colorectal cancer, gastric cancer, and an early-onset astrocytoma. More research needs to be done to better understand this new hereditary polyposis/cancer syndrome.

Why are we sharing this with you? We know that some of you on Kintalk may not have a specific hereditary cancer syndrome diagnosis but are looking for information. This new gene may help identify individuals who have had unexplainable colorectal polyposis and cancer diagnoses. This new hereditary polyp and cancer syndrome is autosomal recessive. This means that you may not see a family history of  cancer. Or you may only see  a group of siblings that all have the same colon polyps and GI cancers. If you have a personal or family history of multiple colon polyps (the adenomatous type) and GI cancers and have tested negative for Lynch syndrome or FAP then you may want to talk with your genetic counselor about this new recessive hereditary polyposis/ cancer syndrome.



Exome Sequencing Identifies Biallelic MSH3 Germline Mutations as a Recessive Subtype of Colorectal Adenomatous Polyposis

August 3rd, 2016

Women with BRCA Gene Mutation Need More Education on Impact of Cancer Risk Reducing Surgeries

img_women_3 As we know, women who are diagnosed with Hereditary Breast and Ovarian Cancer (HBOC) Syndrome have an increased risk
of breast and ovarian cancer. In order to reduce the risk of these cancers surgical recommendations are often made. While these surgeries dramatically reduce a women's risk of breast and ovarian cancer, a recent study found that many women with BRCA gene mutations are not fully educated on how these surgeries will impact their sexuality and other aspects of their lives. The study found that women who underwent the surgeries with little education on the impact of these surgeries suffered on a personal level.

Why are we sharing this? We know that these risk reducing surgeries can save the lives of women with HBOC Syndrome. However, it is important to understand how these surgeries will impact ones life. Counseling and education on topics like surgical menopause should be sought. Discussing the impact of these surgeries on sexuality and life style should be discussed with ones providers as well as those who have already undergone the surgeries. It can also be helpful if a husband/partner participates in these educational discussions so that they can be on the same page and help support a women through these big life and body changes. Education and discussion with ones providers will help in preparing for these surgeries.

To read the article click on this link:

Women Need More Information to Cope With Aftermath of BRCA-Prompted Preventive Surgery

To learn more about surgical menopause due to a risk reducing salpingo oppherectomy:

Surgical Menopause with Dr Goldman

May 3rd, 2016

New Clinic Focused on Hereditary Breast and Ovarian Cancer (BRCA1 or BRCA2 mutation), Lynch Syndrome, and Other Inherited Cancer Conditions

Do yoScreen Shot 2016-05-03 at 11.09.27 AMu or your family members have an inherited risk for cancer because of a BRCA1 or BRCA2 mutation, Lynch Syndrome or a mutation in ATM, CHEK2, or another gene? We know that you have a variety of medical and personal concerns related to your hereditary cancer risk. For example, what does this mutation mean for you? For your family members? Where do you go to find the specialists you need? How can you learn about the latest research?

We are excited to announce a new UCSF program focused on hereditary cancer including BRCA1 and BRCA2 mutations, Lynch Syndrome, and other inherited cancer conditions. The Center for BRCA Research brings together research, education, and coordinated expert clinical care. The clinical work is based in the Hereditary Cancer Clinic, located at the Mt. Zion campus at 1600 Divisadero Street in San Francisco. The goal of the clinic is to provide one place where patients can come for information and education, support, and coordinated clinical care.

Hereditary Cancer Clinic services include:

  • Genetic counselors to offer medical information and personal support before and after genetic testing, as well as follow-up for patients who had counseling in the past and want to learn the most up-to-date information for themselves and their family members
  • Nurse Practitioner to discuss and provide many types of screening, including clinical breast exams and ordering procedures such as mammograms, MRIs, colonoscopy, and others
  • Specialist physicians for more complex cancer screening and other medical care related to hereditary cancer. Some physicians will come to special clinics in the Hereditary Cancer Clinic space, and in other cases, our practice assistant can help you to schedule an appointment with the physicians in their own clinics
  • New research opportunities for cancer screening and prevention

The Hereditary Cancer Clinic is now open and taking appointments for patients who have mutations or want to learn more about the mutation in their family. We are located at the Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, H Building, 4th Floor (Mt. Zion Campus)

To make an appointment with our providers, please call (415) 353-9797 and our practice assistant will assist with scheduling and information or visit The Center for BRCA Reseacher's website:

The Hereditary Cancer Clinic team:

Director:  Dr. Pamela MunsterScreen Shot 2016-05-03 at 11.07.53 AM

Fellow:  Dr. Mallika Dhawan

Nurse Practitioner:  Kelly Williams

Genetic Counselors:  Niki Lovick;  Julie Mak

Clinical Research Coordinator: Kerry Inokuchi

Program Manager: Pagan Morris

Practice Manager: Jessica Davis

Practice Assistant: Meron Abbay

Twitter: @BRCA_UCSF
Facebook: UCSF Helen Diller Family Comprehensive Cancer Center