Increasing genetic screening and advancing the understanding of inherited risk factors in diverse populations.

Impact

Genetic analysis and medical follow-up services for breast and ovarian cancer risk are among the best in the world for Jewish women in the Middle East. However, no such services existed for women of other ancestries in the same region before the Middle East Breast Cancer Study (MEBCS) was launched to address these disparities. The goals of the study, led by Drs. Moien Kanaan, Ephrat Levy-Lahad, and Mary-Claire King, are to understand the inherited breast cancer risk among Palestinian and Arab-Israeli women and to establish the necessary infrastructure for cancer genetics services for women in this population.

Progress Thus Far

As a result of the MEBCS efforts, genetic testing is now routinely undertaken at most major Palestinian hospitals for women diagnosed with breast cancer. The MEBCS team has now conducted genetic testing of more than 1,400 patients of Arab ancestry, the largest cohort of Arab women in the world to undergo such testing. Drs. Kanaan, Levy-Lahad, and King have identified both common and new genetic causes of inherited breast cancer, which provides critical information about treatment and breast cancer prevention for these families and to women worldwide with the same types of mutations. The team has uncovered links between mutations leading to cancer-related syndromes in children and breast and ovarian cancer in their mothers, as well as discovered a previously unknown BRCA2 and PALB2 mutations. In addition, the MEBCS has continued expanding next generation sequencing services, training scientists, and training more nurses and social workers to provide cancer genetics counseling. 

What’s next

The MEBCS will continue to work in their core areas of focus:

• Identify the spectrum of mutations responsible for inherited susceptibility to breast cancer in the Middle Eastern population and evaluate their relevance.
• Assess cancer risks in families with mutations through genetic testing of both affected and unaffected family members.
• Conduct genomic analyses of severely affected Palestinian families with no mutation in any known breast cancer gene. This work is focused on identifying novel classes of gene mutations and even novel breast cancer predisposing genes that might explain the high prevalence of breast cancer among these families.
• Enlarge infrastructure for breast and ovarian cancer genetics services in the Palestinian Authority, including increasing the workforce through mentorship and training and increasing laboratory capacity to perform genetic analysis.