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Breast and Ovarian cancers rank the 1st and 3rd commonest cancers among women in India accounting for 2,00,000 new cases a year. 10-15% of these cancers are hereditary, i.e., occur in different generations of the same family due to mutations in genes like BRCA1, BRCA2, TP53, CHEK2, PALB2, RAD50, etc. Identification of these families by appropriate genetic testing gives a remarkable opportunity to save lives by “precision prevention”. Through proper surveillance and risk-reducing surgeries, we can prevent new cancers in these patients and their unaffected children, siblings, and other family members.
Recognizing these high-risk families is a huge unmet need in India where cancer genetic clinics are rare. Detecting mutations in one patient gives leads to the detection of unsuspected mutations in their unaffected family members, by cascade single-site testing. Thus, accurate testing is the key to the success of such precision prevention programs.
Next-generation sequencing technology is now available in India, and newer mutations and genes are being identified in the Indian population along with a huge number of VUS (variants of unknown significance). Indian genetic makeup is multi-ethnic, and it is expected that the spectrum and frequency of germline genetic mutations will be different from the west.
This is a registry of HBOC mutations that will collate, curate, and share the mutational profile of our HBOC patients along with their clinical, treatment, and outcome details in a deidentified manner via this website. The registry will also audit the prescription, acceptance, outcomes, and efficacy of the risk reduction approaches; both surgical and non-surgical. It will provide timely risk-reduction recommendations, continuous lifelong updates, follow-up, and surveillance reminders to high-risk individuals. It envisages setting up a shared online database of mutations in Indian patients which will improve reporting and decrease VUS rates.
The reference base of mutations and VUS set up by this registry will be accessible to all registered users and this will immediately improve the quality of reporting of multigene hereditary panel tests offered to Indian patients. It will also have a germline DNA repository ready for advanced research as technology advances. The Germline DNA repository will keep us in a “future-ready” mode so that whenever a new technology arrives in the future, we have the samples and clinical information ready to offer. Public awareness programs will be conducted under the aegis of this registry.