Las mujeres con síndrome hereditario de cáncer de mama y de ovario representan un grupo único de pacientes, con riesgo de desarrollar cáncer de mama y ovario, entre otros tumores, a edades tempranas. Este síndrome se asocia a mutaciones de la línea germinal en los genes BRCA1 y BRCA2 y otros genes relacionados con las vías de reparación del ADN. La evidencia emergente indica que estos procesos están alterados por numerosos mecanismos, tanto en cánceres hereditarios como en esporádicos. En conjunto, los tumores con características de aquellos con el síndrome BRCA, que no presentan dicha mutación, se denominan "BRCAness”. Los mecanismos moleculares que subyacen a estas alteraciones pueden tener importantes implicancias pronósticas, terapéuticas y para el asesoramiento genético de estas pacientes.

Urinary metabolites of organophosphate (OP) and pyrethroid (PYR) pesticides and biomarkers of effects were studied in a population (n=40) residing in an important agricultural area of the province of Córdoba (Argentina). Detection frequencies (DF) higher than 85% were observed for the metabolites of pirimiphos (2-diethylamino-6-methylpyrimidin-4-ol –DEAMPY-, median 7.5 μg/g creatinine, DF: 100%), parathion (p-nitrophenol, 0.99 μg/g creatinine, 100%), and chlorpyrifos (3,5,6-trichloro-2-pyridinol, 0.25 μg/g creatinine, 85%). The DEAMPY concentrations doubled the levels found in other studies and were negatively associated with Er-AChE activity, suggesting the appearance of health effects already in environmental exposure levels below established acceptable daily intakes (ADIs). 3-Phenoxybenzoic acid, the metabolite of several PYR pesticides, was also found in all samples. This metabolite was also significantly negatively correlated with Er-AChE, indicating effects of pyrethroid pesticides on the acetylcholine system even at concentrations below the ADI.

INTRODUCCIÓN: la formación de acrilamida (AA) en alimentos que fueron sometidos a tratamiento térmico,fue un descubrimiento inesperado en abril del 2002 por la Universidad de Estocolmo y la AdministraciónNacional de Alimentos de Suecia (NFA).Esta sustancia potencialmente tóxica y su metabolito glicidamida (GA) se forman en muchos alimentos cocidosa temperaturas elevadas.OBJETIVO: en virtud de que no hay estudios de estas sustancias químicas, en células vegetales, el objetivo fuecomprobar el efecto genotóxico de la AA y GA en células de Allium cepa.MATERIALY MÉTODO: se determinó el efecto citotóxico a través del crecimiento de la raíz, actividadproliferativa y las aberraciones cromosómicas de la AA y GA en células meristemáticas de Allium cepa,expuestas a diferentes tiempos y concentraciones, evaluando el crecimiento de la raíz, la actividad proliferativay las aberraciones cromosómicas.RESULTADOS: GA causa una inhibición del crecimiento de la raíz cuya intensidad depende de laconcentración en un medio dado y la AA no muestra diferencias estadísticamente significativas respecto alcontrol. La GA bloquea el ciclo de división celular en una etapa previa a la mitosis y no ocurre lo mismo conla AA. En cuanto a los efectos clastogénicos la GA induce estos efectos en las raíces meristemáticas de Alliumcepa, en cambio la AA no los produce.CONCLUSIONES: en este estudio, aunque las concentraciones de AA y GA son mucho más altas que loniveles de exposición alimentaria en humanos, la GA fue claramente genotóxica para células vegetales, a unadeterminada concentración, con una marcada citotoxicidad. Por lo tanto, nos permitió distinguir las diferenciasentre AA y GA.

The characterization of the population exposed to pesticides and the use of effective biomarkers to evaluate potential health effects are determinant to identify vulnerable groups, understanding the causality of diverse pathologies and propose prevention policies. This is particularly important in countries where intensive agricultural practices had an explosive expansion in last decades. The aim of this study was assessing the usefulness of two exposure indexes questionnaire-based: Intensity Level of the pesticide Exposure (ILE) and Cumulative Exposure Index (CEI) and their scales, in terrestrial applicators of pesticide from the Province of Córdoba (Argentina). The analysis was performed contrasting ILE and CEI results with perceived symptomatology, in addition to effect and exposure biomarkers. A cross-sectional study was designed to compare pesticides body burdens and effect biomarkers between subjects occupationally (OE) and non-occupationally exposed (NOE) to pesticides. Prevalence of perceived symptomatology and genotoxicity damage was higher in the OE group. The exposure condition was the only variable explaining these differences. Significant associations were found between CEI and neurologic symptomatology (p < 0.05) and between ILE and plasmatic cholinesterase (p < 0.1). However, residues of HCB, β-HCH, α-endosulfan, pp'DDE, endrin, β-endosulfan, pp'DDT, endosulfan sulfate and mirex were found in blood samples from both groups. To our knowledge, this is the first report on pesticides body burdens in occupational exposure settings in Argentina. So far, our current results indicate that the occupational condition affects the health of the workers. Significant associations found between symptomatology and biomarkers with scales of CEI and ILE suggest their usefulness to verify different levels of exposure. Further research is necessary to propose these indexes as an affordable tool for occupational health surveillance in areas with difficult access to health care centres.

Los plaguicidas configuran un aspecto central de las prácticas agrícolas. OBJETIVOS: Describir la distribución espacial de la exposición a plaguicidas en Argentina y su asociación con indicadores de carga de cáncer, construir índices de exposición global y validar índices de exposición individual con biomarcadores de efecto en sujetos laboralmente expuestos. MÉTODOS: Se construyeron dos índices globales (de exposición a plaguicidas [IEP] y de impacto ambiental total [IIAT]), se estudiaron sus distribuciones espaciales y mediante un estudio ecológico a nivel nacional se estimó la asociación con las tasas de mortalidad de cáncer total, mama y próstata, usando los departamentos como nivel de desagregación (n=564). Dos índices de exposición, construidos con información (individual) de agroaplicadores de Córdoba, se validaron mediante biomarcadores (actividad de butirilcolinesterasa y genotoxicidad). RESULTADOS: El área pampeana agrupa un IEP mayor al promedio nacional y los IIAT superiores, correspondientes al 2,4-D y clorpirifos. El aumento en ambos índices de exposición se asoció a incrementos en las tasas de mortalidad por cáncer a nivel departamental. El daño genotóxico en aplicadores no se asoció a los niveles de exposición; sí la disminución de la actividad de butirilcolinesterasa. CONCLUSIONES: Los instrumentos —índices— y resultados alcanzados brindan valiosos elementos para vigilar la exposición a plaguicidas en Argentina.

Cyanobacteria can produce potent natural toxins known as cyanotoxins. Blooms of cyanobacteria, produced mainly as result of the pollution of water bodies with excessive amounts of phosphorus, represent a severe environmental problem; not only do they affect the normal equilibrium of the aquatic ecosystem but may also affect animal and human health. The occurrence of algal blooms have been increasing globally (it has been recently reported in at least 100 countries) and it has been considered by WHO as an emerging public health issue. The toxic effects of cyanotoxins have been thoroughly demonstrated in laboratory experiments, however, the effects on humans and the extent of these effects have been more difficult to assess. Epidemiological research is difficult as there are no specific symptoms or routine biomarkers to diagnose intoxication with cyanotoxins, in particular those cases associated with chronic exposure. The objectives of this study were to assess the exposure of a population settled near a lake with recurrent cyanobacteria blooms and to investigate the presence of biological markers of chronic exposure to cyanotoxins, in particular the microcystins (MCs). We first investigated the exposure of the population to cyanobacteria by using a questionnaire on how the population used the water and by analyzing water samples for the presence of cyanobacteria and total microcystins (TMCs). Secondly, we investigated the presence of biological indicators by analyzing the biochemical and immunological parameters in sera of the exposed population. The questionnaires and the water analyses revealed that the population under study (n = 47) is exposed to several exposure routes. The biochemical analyses of the sera showed the alteration of at least one hepatic enzyme in 25% of the exposed people, but this cannot be associated solely to MCs exposure. On the contrary, the immunological analyses, which included microcystin-LR specific antibodies IgE and IgG, showed significant differences between the exposed and non-exposed groups. The presence of MCs specific antibodies confirms the exposure to MCs. We propose the study of specific antibodies as a non-complex biomarker to detect chronic exposure to the toxin and to assist epidemiological studies.

OBJECTIVE:To assess the level of exposure to pesticides and its correlation with perceived health indicators and injury biomarkers (genotoxic alterations and those caused by butyrylcholinesterase enzyme activity) in the population of pesticide applicators in extensive crops (PAEC) in Córdoba, Argentina. METHODS:Transversal study, in PAEC (n = 47) randomly selected from a sample of 2000, and non-exposed subject controls (n = 52). The sociodemographic variables, exposure conditioning, and perceived health were surveyed by means of a self-administered questionnaire; biological indicators of genotoxicity: micronuclei, chromosomal aberrations and kite assay, and butyrylcholinesterase activity. RESULTS:40% of PAEC have over 10 years' length of service and almost 50% of them reside less than 500 m from the sprinkled fields; they report low rates of personal protective equipment use while mixing, applying, or repairing the equipment. General, cardio-respiratory, and dermatological symptoms were greater among PAEC (p <0.05) as well as indicators of genotoxic injury (p <0.001). The butyrylcholinesterase activity was negatively associated with levels of exposure to pesticides. CONCLUSIONS:The PAEC show an important negative impact on health linked to exposure to pesticides. The exposure scales associated to the use of biomarkers were a useful tool for monitoring pesticide applicators' health.

Resumen: Objetivo: Evaluar el nivel de exposición a plaguicidas y su correlación con indicadores de salud percibida y biomarcadores de daño (alteraciones genotóxicas y de actividad enzimática de la butirilcolinesterasa), en la población de agroaplicadores de cultivos extensivos (ACE) de la Provincia de Córdoba, Argentina. Método: Estudio transversal, en ACE (n = 47) seleccionados aleatoriamente de una muestra de 2000, y sujetos no expuestos controles (n = 52). Se relevaron variables sociodemográficas, condicionantes de exposición y de salud percibida, mediante cuestionario autoadministrado; indicadores biológicos de genotoxicidad: micronúcleos, aberraciones cromosómicas y ensayo cometa, y actividad de butirilcolinesterasa. Resultados: El 40% de los ACE tiene una antigüedad mayor de 10 años y casi el 50% reside a menos de 500 m de campos asperjados; reportan bajas tasas de uso de equipo de protección personal durante la mezcla, aplicación o reparación de equipos. Los síntomas generales, cardiorrespiratorios y dermatológicos fueron mayores entre los ACE (p <0,05), así como los indicadores de daño genotóxico (p <0,001). La actividad butirilcolinesterasa se asoció negativamente a niveles de exposición a plaguicidas. Conclusiones: Los ACE presentan un importante impacto negativo en la salud vinculado a la exposición a plaguicidas. Las escalas de exposición asociadas al uso de biomarcadores resultaron una herramienta útil para la vigilancia de la salud de los agroaplicadores. Abstract: Objective: To assess the level of exposure to pesticides and its correlation with perceived health indicators and injury biomarkers (genotoxic alterations and those caused by butyrylcholinesterase enzyme activity) in the population of pesticide applicators in extensive crops (PAEC) in Córdoba, Argentina. Methods: Transversal study, in PAEC (n = 47) randomly selected from a sample of 2000, and non-exposed subject controls (n = 52). The sociodemographic variables, exposure conditioning, and perceived health were surveyed by means of a self-administered questionnaire; biological indicators of genotoxicity: micronuclei, chromosomal aberrations and kite assay, and butyrylcholinesterase activity. Results: 40% of PAEC have over 10 years’ length of service and almost 50% of them reside less than 500 m from the sprinkled fields; they report low rates of personal protective equipment use while mixing, applying, or repairing the equipment. General, cardio-respiratory, and dermatological symptoms were greater among PAEC (p <0.05) as well as indicators of genotoxic injury (p <0.001). The butyrylcholinesterase activity was negatively associated with levels of exposure to pesticides. Conclusions: The PAEC show an important negative impact on health linked to exposure to pesticides. The exposure scales associated to the use of biomarkers were a useful tool for monitoring pesticide applicators’ health. Palabras clave: Biomonitoreo, Vigilancia epidemiológica, Exposición a plaguicidas, Agroaplicadores, Argentina, Keywords: Biomonitoring, Pesticide exposure, Epidemiological surveillance, Pesticide applicators, Argentina

Objective: to present our 19 years’ experience in the management of oligodendroglioma brain tumors in adults. Materials and Methods: From a series of 505 adult patients with brain tumors operated on from January 1991 to December 2009, 30 cases (5.9%) were histopathologically diagnosed as oligodendrogliomas. Twenty-six of them achieved a good follow-up. Results: from the 26 patients, the age ranged between 23 and 72 years. Histological diagnosis showed pure oligodendrogliomas in 17 patients and 9 cases of oligoastrocytomas. Ki-67 immunohistochemistry was performed in 23 patients: in 16 positivity was less than or equal to 5% and in 7 it was greater than 5%. Chromosomes 1p and 19q were studied in 12 patients with positive co-deletion in 2 and negative in the other 10. Twenty patients were operated on,3 received radiation therapy and chemotherapy, and 1 brachytherapy with Iodine-125 and two were not operated on (because the diagnosis was incidental, the tumor was small and was located in the motor area). Currently, 19 patients are alive (73%) and 7 died (27%). Mean survival time of the deceased patients was 7 years and 2 months and a median of 5 years and 8 months. Conclusion: it is not possible to make statistical analysis because small number of cases, although total removal seems to be the best treatment option, due to our small series of cases, we hope randomized double-blinded future studies will clear up the best choice of diagnosis and treatment.

INTRODUCTION: Pesticides are a key factor of agricultural practices. OBJECTIVES: To describe the spatial distribution of pesticide exposure in Argentina and its association with cancer burden indicators, build global exposure indices, and validate individual exposure indices with biomarkers of effect in occupationally exposed subjects. METHODS: Two global indices were developed (pesticide exposure [PEI] and total environmental impact [TEII]), their spatial distribution was studied and, by means of a nationwide ecological study, the association with total, breast and prostate cancer mortality rates was estimated, using departments as level of spatial disaggregation (n=564). Two exposure indices, built with (individual) information of pesticide applicators in Cordoba, were validated using biomarkers (butyrylcholinesterase and genotoxicity). RESULTS: The Pampas have a PEI which is higher than national average as well as the highest TEII, corresponding to 2.4-D and chlorpyrifos. The increase in both exposure indices was associated to increases in the mortality rates due to cancer at the departmental level. Genotoxic damage in applicators was not associated to levels of exposure; what was associated was the reduction of butyrylcholinesterase activity. CONCLUSIONS: The instruments —indices— and results obtained provide valuable elements for the surveillance of pesticide exposure in Argentina.

This review emphasizes, specifically, the determination of fumonisins in different food substrates, made in different commercial centers of Córdoba, Argentina. The importance of reviewing this research is related to public health, since food is part of human development and this must be safe. These contaminations, which we try to determine in different food substrates, in some cases occurred in very small quantities, but in most cases, the consumption is through the children and for long periods of time. Among these foods are those based on corn, this cereal has a great possibility of being contaminated with fumonisins and other mycotoxins as evidenced by research conducted in our country.

Ochratoxin A (OTA) is a mycotoxin that contaminates a wide variety of foods such as cereals, beer, wine, coffee, cocoa, grapes, raisins and spices. It possibly affects the genetic material of organisms that are in contact with the OTA, causing mutation in their DNA. The aim of this study was to evaluate the presence of the OTA-producing fungi in raisins, its detection and the induction of chromosomal aberrations using the Allium cepa test. Samples of dried grapes were studied in which the microflora and the presence and content of OTA were determined. Allium cepa roots were exposed to OTA content (12 and 15 ng ml-1) for 48 h. Then they were collected from each assay and analyzed. OTA induces alterations in the genetic material of plant cells which suggests that OTA presents genotoxic effects at the concentration studied.

Pesticides are an important aspect of agricultural practices in developed and developing countries and, despite the technological advances, the increase yields were achieved mainly through the use of fertilizers and pesticides. Terrestrial pesticides applicators deal the highest levels of exposure. The assessment of pesticides exposure through the characterization of personal and contextual factors and the detection of indicators of health effects are determinants to plan preventive and surveillance proposals adapted to the local context. Objective: to classify pesticides applicators into percentile of two exposure indexes, the exposure intensity and the accumulated exposure, and associate those levels of exposure with perceived health indicators and effect biomarkers in Córdoba. Methods: a questionnaire, including bio-socio-cultural characteristics and perceived health variables was applied and effect biomarkers were measured (butirylcholinesterase, comet assay, micronuclei and chromosomal aberrations) in a samples of pesticide applicators (n=47). To estimate the associations between pesticides exposure and health results different generalized linear models were fitted. Results: higher levels of the exposure indexes were associated with lower levels of the enzymatic activity, showing the usefulness of the indexes to discriminate groups with different exposure levels and reflecting an advance in the field of surveillance tools. The higher levels of genotoxic damage found among the applicators were not correlated with the indexes. This could indicate how early the damage is installed. The Argentinean regulation law recommends an annual measurement of the enzymatic activity. According to our results, one single measure may not have a meaningful result, as far as it impairs making preventive advises. In conclusions, chronic exposures to low-doses of pesticides mixtures address toxicological interactions making difficult to choose one appropriate effect biomarker.

Introduction: Argentina is one of the major crop producers in Latin America. In this context, the agricultural workers, their families, and particularly the children, represent a population that is highly vulnerable to the toxic effects of the pesticide use. The aim of this study was to evaluate the genotoxic damage (GD) in children potentially exposed to pesticides in their environmental context. Methods: An observational, cross sectional study was conducted, among children whose parents are pesticide applicators (n=22), in the Pampean region of Cordoba Province. To assess determinants of exposure and child health conditions a questionnaire was implemented. Samples of the oral mucosa were obtained to determine GD using micronucleus frequency (MN). Genotoxicity was correlated with variables of the exposure context, such as the distance from home to crops, distance from the schools to sprayed fields, practices like washing work clothes in the home and agricultural pesticides use in the home. Results: The children were aged between 6 and 14 years of age. Average MN count were found in 2.6 (SD 0.54). 36% of the children live within 500 m of sprayed fields; for 59% of them, school is less than 500 m to crops. All the families reported the use of pesticides at home, 23% of them were agricultural use pesticides; 18% reported washing work clothes with family laundry. Four children worked with their father, without using any personal protective element. GD was associated with distance from the school to the crops (p=0.05). Conclusion: This study provides evidence of GD in children living in the Pampean region. The environment of daily life of children shows a scenario of continuous exposure to pesticides. Further studies that include a broader population sample and the existence of a control group, are necessary to obtain a better level of evidence in relation to the problems of pesticide exposure, genetic biomonitoring and public health surveillance.

The discovery of BRCA1 and BRCA2 genes has led to the introduction of increasingly sophisticated genetic tests to measure the risk of hereditary breast cancer, among other things.The aim of this study was to determine the prevalence of the mutation in 24 women from Córdoba with breast / ovarian cancer (BC / OC) and with at least two relatives with breast cancer.Although there are recurrent mutations, which appear repeatedly in unrelated families, with highest prevalence as in the Jewish ethnicity, this is the first study on the population of the province of Córdoba, Argentina.

Pesticides are a central aspect of agricultural modern practices. However, only a small percentage of the total applied reach the target pests, the rest being deposited in abiotic components and non-target organisms, affecting Public Health and the environment. Pesticides can inhibit enzymes activity, cause genotoxic effects and can be associated with cancer, neurological, neuro-cognitive and reproductive disorders, endocrine disruption and congenital malformations. The risks of chronic toxicity occur frequently in agricultural workers. In Argentina, agricultural activity is the main source of country income and pesticide use has not been extensively studied in relation to health risks. We enrolled 47 exposed and 52 non-exposed subjects in the frame of the terrestrial pesticides applicators study (ATePAS) being conducted in Córdoba, to study genotoxic and biochemical parameters as effect biomarkers of chronic exposure and, perceived health. Working practices, bio-socio-cultural characteristics and perceived symptoms were obtained by questionnaire and blood and urinary samples were collected. Genotoxic damage (GD) was evaluated by Chromosomical Aberrations (CA), Sister Chromatid Exchange (SCE), Micronuclei (MN) and Comet (C) Assay; several biochemical parameters were also assessed. General clinical, cardio-respiratory and dermal symptoms were significant different among exposed and non exposed while neurological or gastric symptoms did not differ among groups. Both groups had similar serum cholinesterase activity and other biochemical parameters. Significant higher genotoxic damage was found in exposed subjects as indicated by SCE, MN, CA and C assays (2.99; 2.72; 0.86 and 19 points higher respectively). Genotoxic damage was associated with cardio-respiratory symptoms. These results deserve future monitoring of these subjects to assess changes in the health status of individuals with genetic damage and the effects on those with changes in exposure status.

Purpose: La identificacion de genes especificos o regiones de cromosomas involucrados con el desarrollo de determinados tumores puede ayudar al diagnostico, formular prognosticos, monitorear pacientes y eventualmente desarrollar terapias selectivas. Materials and Methods: Se estudiaron 80 tumores solidos procedentes de cirugia: vejiga (n= 28) obtenido por reseccion endoscopica transuretral, prostata (n=24) y rinon (n= 28) recolectados en el acto operatorio en fresco. Las muestras fueron recibidas en Anatomia Patologica para su estudio histopatologico y una porcion del tumor fue utilizado para realizar cultivo de tejidos y posterior estudio citogenetico. Results: En los tumores de vejiga la del (9)(p21) fue detectada en 17 de 28 casos, el 60,7 % de los tumores. La del(11)(p13) ocurrio en 6 (21,4%) de 28 tumores. La t (1;14)(q22;q32) fue observada en 5 casos, el 17,8 % de los tumores. En los tumores renales la del (3)(p13) fue detectado en 18 (64 %) de 28 tumores. La del(14)(q24) fue detectada en 10 de 28 tumores (35,7 %). En este estudio, la citogenetica en tumores de prostata con grado Gleason 7, 8 y 9 mostro aneuploidia del cromosoma 7 en 16 tumores (66,6 %). Ademas se hallaron en 8 tumores (33,3 %) con grado Gleason 9 la del (16)(q24). Conclusions: En los tumores de vejiga, el hallazgo mas interesante fue la t(1;14)(q22;q32) en vejigas hiperplasicas, que en el tiempo se transformaron en carcinoma transicional. La citogenetica anticipo la evolucion neoplasica, aspecto este que requiere de futuras investigaciones para determinar si se repiten estas alteraciones neoplasicas en vejigas hiperplasicas. Este estudio sugiere que el marcador genetico del sitio cromosomico 14q, puede predecir la evolucion clinica del carcinoma renal de celulas claras. En cuanto a los tumores de prostata el hallazgo mas importante aparte de la tri 7, fue la del (16)(q24). Esto sugiere que el marcador genetico de este sitio cromosomico puede predecir el potencial metastasico del tumor.

El descubrimiento de los genes BRCA1 y BRCA 2 ha llevado a la introduccion de pruebas geneticas cada vez mas sofisticadas para medir el riesgo de cancer de mama de origen hereditario, entre otras cosas. Por otra parte, el mas comun de los sindromes de cancer de colon hereditario no asociado a poliposis (CCHNP), es una enfermedad hereditaria con herencia autosomica dominante y corresponde a la predisposicion genetica a sufrir cancer colorrectal mas frecuente. El objetivo del presente trabajo es determinar la prevalencia de la mutacion en mujeres con cancer de mama/ovario (CM/CO) y la mutacion de la Inestabilidad de Microsatelites (IMS) en personas con cancer de colon de Cordoba. El mejor conocimiento de las bases geneticas del cancer, junto con la identificacion de diversos genes asociados a sindromes de predisposicion hereditaria al cancer y el desarrollo de diversas tecnicas de laboratorio, ha abierto la posibilidad de ofrecer asesoramiento genetico especializado a individuos y familias en situacion de riesgo. La identificacion de estos individuos y familias permite, ademas de una valoracion individualizada del riesgo de desarrollar cancer, recomendar estrategias de prevencion y cribado adecuadas al riesgo estimado que hayan demostrado su efectividad en la reduccion de la incidencia y mortalidad por cancer.

Como ocurre en numerosas enfermedades comunes, la historia familiar influye en la probabilidad de tener cancer. El riesgo de cancer de mama, de colon, o de cancer de otro tipo, es aproximadamente el doble cuando se tiene un familiar de primer grado que ha tenido ese cancer a una edad media y, ademas, ese riesgo puede ser mucho mayor en algunas familias. Se ha estimado que hasta un 5% de todos los canceres son hereditarios y los miembros de las familias con formas hereditarias tendran los riesgos mas elevados para desarrollar cancer y, con una elevada probabilidad, el cancer aparecera a una edad mas temprana de la habitual. El conocimiento de los antecedentes familiares de cancer puede ayudar a prevenir la enfermedad a facilitar un diagnostico precoz. La interpretacion del riesgo familiar requiere la recogida sistematica de la informacion familiar y su valoracion en detalle en el seno del proceso de consejo genetico, la mejor herramienta para evaluar una posible mayor susceptibilidad al cancer en una determinada familia.