Instruction 3 Learning Modules

Time 2.50 Hours

Tasks 3 Quizzes

Basic Genetics Primer, Part 1

• Describe the basic principles of gene structure, function, and regulation
• Appreciate the nature and consequences of major types of gene mutations

Basic Genetics Primer, Part 2

• Outline the principles of Mendelian inheritance
• Identify the features of incomplete penetrance and variable expressivity
• Recognize how genetic mechanisms such as de novo mutations, mosaicism and imprinting can affect the pattern of cancer in a family

The Basic Science of Cancer Genetics

• Distinguish the differences between somatic and germline mutations
• Describe the roles of oncogenes and tumor suppressor genes in signal transduction and cell cycle control
• Review the mechanisms of DNA damage

Instruction 6 Learning Modules & 1 Micro Learning

Time 6.00 Hours

Tasks 6 Quizzes

The Fundamentals of GCRA

• Describe fundamentals of the genetic cancer risk assessment (GCRA) process
• Take a comprehensive cancer family history
• Explain the importance of and strategies for confirming key cancers
• Identify sporadic, familial, and hereditary cancer patterns

Documenting the Cancer Family History

• Recognize the importance of eliciting, documenting and verifying the patient family history
• Collect family history information, focusing on details and questions relevant to cancer history documentation
• Draw a 3-4 generation pedigree using standard pedigree nomenclature and symbols
• Demonstrate skills associated with proficiency in collecting and documenting the family history of cancers

Reading the Pathology Report through the Genomics Lens

• Apply reading and interpreting pathology reports to define cancer stage and extract information on histology/molecular features
• Describe the roles of other diagnostic data (imaging, CT scans, blood marker

Laboratory Methods for Inherited Cancer Susceptibilities

• Identify the methods, benefits, and limitations of different types of NGS cancer panels
  
• Recognize approaches to variant interpretation and reporting
• Apply understanding of different types of genetic tests to clinical vignettes

Characterization and Clinical Interpretation of Germline Genomic Variants

• Review types of genetic variants
  
• Outline the ACMG standards and guidelines for variant classification
• Describe the methods, resources, and tools used to classify variants
• Discuss approaches to re-classifying variants of uncertain significance (VUS)

Variant Nomenclature: Reading and Interpreting Genetic Test Results

• Recognize various types of genetic variants
• Distinguish between different types of variant nomenclature
• Interpret a genetic test report

Instruction 4 Learning Modules & 2 Micro Learnings

Time 8.00 Hours

Tasks 4 Quizzes & 1 Case Assignment

Hereditary Breast and Ovarian Cancer Syndromes

• Recognize features of high-penetrance hereditary breast and ovarian cancer syndromes
• Describe the genetic etiologies of hereditary breast and ovarian cancer
• Review the impact of founder mutations associated with BRCA1 and BRCA2 hereditary breast and ovarian cancer
• Examine the benefits and limitations of genetic analysis and risk management for hereditary breast/ovarian cancer.

Hereditary Breast and Ovarian Cancer Syndromes: Moderate Risk Genes

• Describe the differences between high, moderate, and low penetrance cancer susceptibility genes
• Recognize that cancer susceptibility genes on clinical panels are not always actionable
• Identify the benefits and limitations in moderate and low penetrance cancer susceptibility genes in clinical multi gene testing panels

Hereditary Breast/Ovarian Cancer Risk Assessment

• Apply mutation probability and empiric risk assessment models for breast cancer
• Formulate an evaluation & management plan

Clinical Management of Hereditary Breast Cancers

• Review the tools for high-risk breast and ovarian cancer screening
• Identify the role and efficacy of breast and ovarian cancer surgical risk reduction
• Recognize the role of chemoprevention options for breast and ovarian cancer risk reduction
• Use evidence-based guidelines to inform risk management recommendations for patients with pathogenic variants in high or moderate penetrance breast and ovarian cancer susceptibility genes
• Apply individualized screening and risk management options and recommendations to case examples

Instruction 4 Learning Modules & 3 Micro Learnings

Time 6.75 Hours

Tasks 4 Quizzes & 1 Case Assignment

Hereditary Gastrointestinal Cancer Syndromes, Part 1: Lynch Syndrome

• Recognize the features of hereditary gastrointestinal and other cancers associated with Lynch Syndrome
• Discuss the methods and limitations of tumor screening for Lynch syndrome
• Identify the features and mode of inheritance of Constitutional Mismatch Repair Deficiency (CMMRD)
• Recognize the characteristics of Familial Colorectal Cancer (CRC) Type X

Significance and Practical Applications for Tumor Phenotyping (IHC/MSI) in Hereditary Cancer Risk Assessment

• Review the mismatch repair (MMR) mechanism and the association of MMR deficiency in Lynch Syndrome
• Recognize the importance of universal MSI/IHC tumor screening on newly diagnosed colorectal and endometrial cancers
• Review EGAPP recommendations
• Utilize MSI/IHC screening results for risk assessment in clinical cases

Hereditary Gastrointestinal Cancer Syndromes, Part 2: Polyposis

• Identify the features distinguishing different hereditary polyposis syndromes
• Recognize the association between polyp histology and potential germline genetic predisposition to a polyposis syndrome
• Discern the features of different polyposis syndromes, including: Familial adenomatous polyposis; MutYH-associated polyposis; Hamartomatous polyposis syndromes; Serrated polyposis syndrome

Hereditary Gastrointestinal Cancer Syndromes, Part 3: Gastric Pancreatic

• Recognize the features of hereditary gastric cancers.
• Recognize the features of hereditary pancreatic cancers.
• Apply appropriate germline genetic testing strategies for hereditary gastrointestinal syndromes.

Instruction 3 Learning Modules & 1 Micro Learning

Time 3.50 Hours

Tasks 3 Quizzes & 1 Case Assignment

Hereditary Endocrine Neoplasias

• Recognize clinical features of hereditary endocrine neoplasia syndromes
• Appreciate risks, benefits and limitations of genetic testing
• Identify resources to inform risk management for individuals with hereditary endocrine neoplasias

Genitourinary Cancer Syndromes

• Recognize inherited urologic disorders associated with kidney cancer
• Distinguish renal tumor pathologies associated with several inherited kidney cancer syndromes
• Identify appropriate kidney cancer patients for genetic counseling/testing

Hereditary Prostate Cancer

• Discuss current genetic etiologies of hereditary prostate cancer
• Recognize features warranting genomic evaluation associated with prostate cancer
• Explain the methods and limitations of genetic analysis for hereditary prostate cancer

Instruction 3 Learning Modules

Time 1.50 Hours

Tasks 3 Quizzes

Pediatric Cancer Syndromes

• Recognize clinical features of hereditary cancer syndromes with pediatric manifestations
• Recognize the conditions under which a pediatric cancer patient should be referred to Clinical Genetics
• Provide education on hereditary cancer syndromes with pediatric manifestations to parents, patients and providers in age appropriate manner

Pediatric Cancer Syndromes: Counseling Issues

• Identify genetic counseling and testing issues associated with pediatric hereditary cancer syndromes
• Review limitations and benefits of different testing strategies
• Describe psychosocial impacts of genetic testing for children

Hereditary Hematologic Cancer Syndromes

• Identify key terminology and basics of hematologic disorder and malignancy subtypes
• Recognize how hematologic disorders can affect tissue selection and genetic test interpretation
• Review the current rationale, care impact, and guidelines for germline genetic evaluation for patients with hematologic disorders and cancers
• Identify patterns suggestive of hereditary hematologic malignancy disorders and expected yields of germline testing

Instruction 2 Learning Modules

Time 1.25 Hours

Tasks 2 Quizzes

Hereditary Genodermatoses

• Define disease characteristics of hereditary syndromes classified as genodermatoses
• Identify the genes associated with hereditary syndromes that have cutaneous manifestations
• Recognize cancer risks associated with hereditary genodermatoses syndromes

Hereditary Melanoma

• Identify characteristics of hereditary melanoma and when to consider genetic testing
• Recognize the genes associated with hereditary melanoma
• Discuss clinical characteristics associated with CDKN2A gene and management recommendations

Instruction 3 Learning Modules & 1 Micro Learning

Time 3.25 Hours

Tasks 3 Quizzes

Tumor/Germline Analysis in GCRA Practice, Part 1

• Identify the distinctions between etiologies of germline and somatic genetics
• Review considerations prior to ordering germline and somatic genomic testing
• Discuss challenges in interpreting somatic testing results
• Recognize confounding somatic phenomena that can be captured in germline testing

Tumor/Germline Analysis in GCRA Practice, Part 2

• Compare the benefits and challenges of somatic panel, germline panel and paired somatic/germline sequencing
• Identify issues related to incidental findings in cancer sequencing
• Discriminate strategies used to interpret genomic data
• Examine ways that genomic data are changing cancer treatment paradigms
• Discuss some of the patient, provider, and system-level challenges to genomic test integration

Navigating Complex Genetic Test Results - Clonal Hematopoiesis

• Review the various possible mechanisms of both germline and somatic mosaicism
• Identify the various mechanisms that can be associated with an altered allelic fraction in a germline genetic test
• Discuss approaches to interpreting, further evaluating and following up on genetic test results reporting low allelic fractions

Instruction 2 Learning Modules & Many Mock Counseling Samples

Time 2.50 Hours

Tasks 2 Quizzes

Ethical, Legal, and Social Issues in Cancer Genetics

• Recognize ethical, legal and social issues relevant to cancer genetics counseling and testing
• Apply bioethical principles to counseling challenges
• Identify emerging legislation protecting against genetic discrimination

Psycho-social and Family Dynamics of Hereditary Cancers 

• Recognize key psychological principles and how they generalize across hereditary cancer syndromes
• Discuss how psychological factors may interact with specific features of hereditary risk
• Review how these processes may effect emotional adjustment, decision-making, quality of life
• Identify family- and individual-level challenges commonly encountered in working with familial risk patients
• Review brief assessments and tools that can be incorporated into cancer risk consultations
• Identify red flags that indicate consideration of referral for psychological support

Mock Counseling Session, Mock Counseling Case Vignettes

• Observe the application of cancer risk assessment and counseling skills in the setting of mock initial and follow up genetic cancer risk assessment (GCRA) consultation sessions.
• Recognize the key elements of a comprehensive GCRA counseling process.
• Review the essential components of the informed consent process for genetic testing.
• Identify how to address ethical, legal and social issues with patients and families.
• Recognize key issues related to genetic test results interpretation, disclosure and communication of personalized risk management recommendations.