Mount Sinai Comprehensive BRCA Program takes ‘patient-centric’ approach
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Genomic testing has afforded today’s patient the advantage of knowing when they harbor a potentially dangerous genetic mutation, such as BRCA1 or BRCA2.
However, when a patient first learns they carry such a mutation, it may feel like anything but an advantage. This news often leads to anxiety, confusion and a sense of being overwhelmed.
“When someone has a BRCA mutation, they’re given a laundry list of doctors to see and tests they need to get,” Stephanie V. Blank, MD, director of gynecologic oncology for Mount Sinai Health System and professor of obstetrics and gynecology at Icahn School of Medicine at Mount Sinai, said in an interview with Healio. “We really want to help patients get the most comprehensive, excellent care in a way that’s as efficient and easy as possible.”
To that end, the Mount Sinai Health System has established a comprehensive BRCA program for all patients, including men, who are BRCA carriers.
Blank spoke with Healio about how the program helps patients navigate the many decisions and challenges of living with a BRCA mutation.
Healio: What does your program offer to people who learn they harbor a BRCA mutation?
Blank: We want to give patients the confidence of knowing they are getting everything done on the schedule they are supposed to follow, in the way it is supposed to be done. We want them to be assured their doctors are working together to optimize and individualize their care. It’s similar to a patient navigation or concierge program, but more than that because part of the program includes individual providers communicating and coordinating care. It’s very patient-centric; we aim to help patients with the decisions they will have to make along the way.
Healio: Does your program recommend or facilitate cascade testing?
Blank: Yes. One of our aims is to facilitate patients’ ability to notify their families. Sometimes people don’t want to share information like that, but if you position it as a potentially lifesaving message a patient can deliver to their family, they are usually more open to it. And we will facilitate getting these family members in for testing.
Healio: Do you help patients navigate decisions around prophylactic mastectomy or oophorectomy?
Blank: Absolutely. Let’s say a patient has a BRCA1 mutation and risk-reducing surgery is recommended. A lot of these patients are young and don’t want to lose their ovaries and go through menopause. We have a study looking at the possibility of just removing the tubes and not necessarily the ovaries. Women also have questions about other side effects of surgical menopause, and we have a comprehensive program including menopause medicine, sexual health and oncofertility programs so people can explore all of these options before they make the decision to proceed with surgery.
Healio: Is this something other institutions could replicate?
Blank: Sure. It requires a group of doctors who are very dedicated to the patient population, can communicate very closely, and can get things done very efficiently. The doctors must really listen to the patients. It’s not just about checking the boxes; it’s about getting to know each patient individually and getting them the services they need as quickly as possible.
Reference:
- Mount Sinai. Comprehensive BRCA program for men and women. Available at: www.mountsinai.org/care/cancer/about/brca-program. Accessed Aug. 25, 2021.
For more information :
Stephanie V. Blank, MD, can be reached at Blavatnik Family Chelsea Medical Center at Mount Sinai, 325 W. 15th St., New York, NY 01111; email: stephanie.blank@mountsinai.org.
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Healio Interview
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