TR: Are there drugs that can protect against cancer?

KO: Sometimes taking drugs like tamoxifen [a drug that interferes with the activity of estrogen and is used to treat breast cancer] can reduce risk in BRCA carriers. But it has risks.

TR: Could the same approach find protective factors for other types of cancer?

KO: In theory, the same approach could be applied to other hereditary cancer syndromes, such as colon cancer, thyroid cancer, or pediatric cancers. The question is whether the same factors that protect women from getting breast cancer or other cancers in the face of strong genetic predisposition will be generalizable to the population at large. We also hope to look at that.

TR: Will the results of the study be useful for genetic screening?

KO: The risk for breast cancer [in BRCA carriers] over the course of a lifetime can range from 30 to 40 percent up to 80 to 90 percent, based on different studies. The hope would be that by mapping modifiers [genetic variants that either increase or decrease risk], we would be able to tell women which end they are closer to.

Women who have mutations that modify risk may well be interested in tailoring their preventive medical management to an adjustment in risk. Someone carrying a series of modifiers that indicate they are at particular risk at early age might elect to have more frequent surveillance or surgical risk reduction.

TR: Will this study lead to new drugs that protect against the development of cancer?

KO: In any gene discovery experiment, the long-term goal is to better understand the biology of the process, which can then serve as the rationale for pharmacologic development. Certainly, the identification of genes that are protective against all the processes in aging, including the increasing cancer risk, would be interesting targets for drug development.