Kelly Metcalfe | |
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Academic background | |
Education | BScN, University of Western Ontario PhD, 2002, University of Toronto |
Thesis | Prophylactic bilateral mastectomy in Ontario (2002) |
Academic work | |
Institutions | University of Toronto |
Kelly A. Metcalfe is a Canadian scientist and a professor at the University of Toronto and at Women's College Hospital. Her work's focus is on understanding the clinical and psychosocial implications of genetic testing for BRCA gene mutations in women,men and their families.
Growing up in Ontario,Metcalfe graduated from St. Joseph's Catholic High School in 1990 and went on to earn her nursing (BscN) degree at the University of Western Ontario. [1] While completing her undergraduate degree,Metcalfe became interested in cancer research after the discovery of the BRCA1 (BReast CAncer one) and BRCA2 genes in 1994 and 1995 respectively. [2] As such,she accepted a research nurse position at Women's College Hospital (WCH) where she became one of the first nurses to study the impact of genetic predispositions to cancer. [1] While researching at WCH,she also completed her PhD in medical science in 2002 at the University of Toronto (U of T). [2]
Upon earning her PhD,Metcalfe returned to WCH and accepted a faculty position at U of T. In 2004,she led a research team in surveying half of 120 women in Ontario who had preventive double mastectomies between 1991 and 2000. [3] Between 2007 and 2011,Metcalfe received funding to help researchers understand the differences in uptake of cancer prevention options in Canadian women with a BRCA1 or BRCA2 mutation. [4] Through this,Metcalfe became the first to investigate the predictors of contralateral breast cancer in women with a BRCA1 or BRCA2 mutations. [5] As such,she received another grant in 2012 while working as U of T's Bloomberg Nursing interim director of research to develop and test a decision support tool for post-mastectomy breast reconstruction. [6]
At the same time,Metcalfe was appointed the Lawrence S. Bloomberg Faculty of Nursing Limited-Term Professor in Cancer Genetics and became an Adjunct Scientist at the Familial Breast Cancer Research Institute at the Women’s College Research Institute. [7] In these roles,she continued to focus on the prevention and treatment of breast and ovarian cancers in high-risk women by collaborating with the Canadian Breast Cancer Foundation and the Canadian Institutes of Health Research. Through these partnerships,she aimed to interview 1200 women with young-onset breast cancer to evaluate the contributions of 25 known breast cancer-causing genes in that population. [8] Metcalfe was subsequently elected an International Fellow of the American Academy of Nursing in 2016. [9] Following her election,Metcalfe was recognized locally with an election to the Royal Society of Canada’s College of New Scholars,Artists and Scientists [10] and was named a Fellow of Canadian Academy of Health Sciences. [11] She also received U of T's Rising Star Alumni Award. [12] That same year,Metcalfe received another grant to fund her study,Breast cancer treatment in women with PALB2 mutations. [13]
In 2018,Metcalfe was appointed Acting Associate Dean,Research &External Affairs for a one year term while Linda McGillis Hall was on administrative leave. [14] Following her one year term,Metcalfe became the co-Principal investigator on a project entitled "Outcomes Associated with Direct Rapid Genetic Testing at Time of Breast Cancer Diagnosis." [15] Her integral role in "investigating the clinical and psychosocial implications of genetic testing for BRCA mutations in women and men" subsequently earned her the Wendy Lack Women of Action Scientific Award. [16] She was also listed among the top 25 nurse researchers in Canada. [17]
Penetrance in genetics is the proportion of individuals carrying a particular variant of a gene (genotype) that also expresses an associated trait (phenotype). In medical genetics,the penetrance of a disease-causing mutation is the proportion of individuals with the mutation that exhibit clinical symptoms among all individuals with such mutation. For example:If a mutation in the gene responsible for a particular autosomal dominant disorder has 75% penetrance,then 75% of those with the mutation will go on to develop the disease,showing its phenotype,whereas 25% will not.
Breast cancer type 1 susceptibility protein is a protein that in humans is encoded by the BRCA1 gene. Orthologs are common in other vertebrate species,whereas invertebrate genomes may encode a more distantly related gene. BRCA1 is a human tumor suppressor gene and is responsible for repairing DNA.
BRCA2 and BRCA2 are human genes and their protein products,respectively. The official symbol and the official name are maintained by the HUGO Gene Nomenclature Committee. One alternative symbol,FANCD1,recognizes its association with the FANC protein complex. Orthologs,styled Brca2 and Brca2,are common in other vertebrate species. BRCA2 is a human tumor suppressor gene,found in all humans;its protein,also called by the synonym breast cancer type 2 susceptibility protein,is responsible for repairing DNA.
Women's College Hospital is a teaching hospital in Toronto,Ontario,Canada. It is located in downtown Toronto at the north end of Hospital Row,a section of University Avenue where several major hospitals are located. It currently functions as an independent ambulatory care hospital.
Mary-Claire King is an American geneticist. She was the first to show that breast cancer can be inherited due to mutations in the gene she called BRCA1. She studies human genetics and is particularly interested in genetic heterogeneity and complex traits. She studies the interaction of genetics and environmental influences and their effects on human conditions such as breast and ovarian cancer,inherited deafness,schizophrenia,HIV,systemic lupus erythematosus and rheumatoid arthritis. She has been the American Cancer Society Professor of the Department of Genome Sciences and of Medical Genetics in the Department of Medicine at the University of Washington since 1995.
Hereditary breast–ovarian cancer syndromes (HBOC) are cancer syndromes that produce higher than normal levels of breast cancer,ovarian cancer and additional cancers in genetically related families. It accounts for 90% of the hereditary cancers. The hereditary factors may be proven or suspected to cause the pattern of breast and ovarian cancer occurrences in the family. The name HBOC may be misleading because it implies that this genetic susceptibility to cancer is mainly in women. In reality,both sexes have the same rates of gene mutations and HBOC can predispose to other cancers including prostate cancer and pancreatic cancer. For this reason,the term "King syndrome" has recently come into use. The new name references Mary-Claire King who identified the genes BRCA1 and BRCA2.
Sharsheret is a nonprofit organization with the goal of supporting Jewish women diagnosed with breast cancer and ovarian cancer. Through its work and research efforts,Sharsheret provides healthcare resources,financial assistance,communal support,and educational programs to thousands of women and their families in the United States. Sharsheret has offices in California,Florida,Illinois,New Jersey and New York. They are headquartered in Teaneck,New Jersey. Sharsheret primarily works with young women and Jewish families as Ashkenazi Jews are at higher risk of carrying a BRCA gene mutation,but also aids men and women from other backgrounds.
A BRCA mutation is a mutation in either of the BRCA1 and BRCA2 genes,which are tumour suppressor genes. Hundreds of different types of mutations in these genes have been identified,some of which have been determined to be harmful,while others have no proven impact. Harmful mutations in these genes may produce a hereditary breast–ovarian cancer syndrome in affected persons. Only 5–10% of breast cancer cases in women are attributed to BRCA1 and BRCA2 mutations,but the impact on women with the gene mutation is more profound. Women with harmful mutations in either BRCA1 or BRCA2 have a risk of breast cancer that is about five times the normal risk,and a risk of ovarian cancer that is about ten to thirty times normal. The risk of breast and ovarian cancer is higher for women with a high-risk BRCA1 mutation than with a BRCA2 mutation. Having a high-risk mutation does not guarantee that the woman will develop any type of cancer,or imply that any cancer that appears was actually caused by the mutation,rather than some other factor.
Thomas M. Kolb is an American radiologist specializing in the detection and diagnosis of breast cancer in young,predominantly high-risk premenopausal women. He has served as an assistant clinical professor of Radiology at Columbia University College of Physicians and Surgeons from 1994–2010. Kolb is double board certified,having received his training in pediatrics at the Albert Einstein College of Medicine in Bronx,New York,and in diagnostic radiology at the Columbia-Presbyterian Medical Center in New York.
In the Family is a 2008 documentary film,produced by Kartemquin Films,about predicting breast and ovarian cancer and the choices women make when they are faced with the dangers of a possible life-threatening disease. The film's director,Joanna Rudnick,tests positive for the familial BRCA mutation that increases her chances of developing breast cancer by 60%. Faced with these odds,Rudnick must examine her choices of possibly taking her chances or possibly having her breasts and ovaries removed.
Sir Bruce Anthony John Ponder FMedSci FAACR FRS FRCP is an English geneticist and cancer researcher. He is Emeritus Professor of Oncology at the University of Cambridge and former director of the Cancer Research UK Cambridge Institute and of the Cancer Research UK Cambridge Cancer Centre.
A hereditary cancer syndrome is a genetic disorder in which inherited genetic mutations in one or more genes predispose the affected individuals to the development of cancer and may also cause early onset of these cancers. Hereditary cancer syndromes often show not only a high lifetime risk of developing cancer,but also the development of multiple independent primary tumors.
Kenneth Offit is an American cancer geneticist and oncologist known for his discoveries with respect to the genetic bases of breast,colorectal,and lymphoid cancers. He is currently Chief of the Clinical Genetics Service and the Robert and Kate Niehaus Chair in Inherited Cancer Genomics at Memorial Sloan Kettering Cancer Center. Offit is also a member of the Program in Cancer Biology and Genetics at the Sloan-Kettering Institute and Professor of Medicine and Healthcare Policy and Research at Weill Cornell Medical College. He was previously a member of both the Board of Scientific Counselors of the National Cancer Institute and the Evaluation of Genomic Applications in Practice and Prevention working group of the U.S. Centers for Disease Control.
A preventive mastectomy or prophylactic mastectomy or risk-reducing mastectomy (RRM) is an elective operation to remove the breasts so that the risk of breast cancer is reduced.
Douglas F. Easton FMedSci is a British epidemiologist who conducts research on the genetics of human cancers. He is Professor of Genetic Epidemiology and Centre for Cancer Genetic Epidemiology at the University of Cambridge. He founded Cambridge's Cancer Research UK Genetic Epidemiology Unit in 1995,and was a Principal Research Fellow there from 2001 to 2011. He is a Professorial Fellow of Homerton College,Cambridge.
Susan M. Domchek is an oncologist at the University of Pennsylvania,Executive Director of the Basser Center for BRCA,the Basser Professor in Oncology at the Perelman School of Medicine,and Director of the Mariann and Robert MacDonald Cancer Risk Evaluation Program at Penn Medicine. She has authored more than 250 articles in scholarly journals. In 2018,Domchek was elected to the National Academy of Medicine.
Maria Jasin is a developmental biologist at the Memorial Sloan Kettering Cancer Center. She is known for studying homologous recombination,a method in which double-strand breaks in DNA strands are repaired,and for discovering the role of BRCA1 and BRCA2 in cancers.
Jórunn Erla Eyfjörð is an Icelandic molecular biologist and professor emerita at the Faculty of Medicine of the University of Iceland. She is known for her research on breast cancer genetics.
Lorraine L. Lipscombe is a Canadian endocrinologist. In 2021,Lipscombe was appointed the director of the University of Toronto's Novo Nordisk Network for Healthy Populations.
Breast and ovarian cancer does not necessarily imply that both cancers occur at the same time,but rather that getting one cancer would lead to the development of the other within a few years. Women with a history of breast cancer have a higher chance of developing ovarian cancer,vice versa.