- With Mayo Clinic genetic counselor
Carrie A. Zabel, M.S., C.G.C.
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Carrie A. Zabel, M.S., C.G.C.
Carrie A. Zabel, M.S., C.G.C.
"We must begin now to prepare for the future; we cannot wait until the details are known or fully understood."*
— David B. Schowalter, M.D., Ph.D., former Mayo geneticist, (*posthumous)
Carrie A. Zabel, M.S., C.G.C., is a board-certified genetic counselor who specializes in hereditary cancer syndromes. One of her main professional interests is the family medical history.
"Recognizing features in the family history which may suggest an underlying single gene disorder can have a huge impact on families," she says. "Identifying a genetic susceptibility gene can allow family members to more accurately understand their risk of disease and empower those who have an increased genetic susceptibility to take control of their medical management and lifestyle factors which may influence this risk."
She received her B.S. in biology from the University of Wisconsin-La Crosse in 2002 and M.S. in genetic counseling from the University of Minnesota in 2004.
She was a clinical genetic counselor at the Marshfield Clinic in Marshfield, Wis., before joining Mayo Clinic in August 2006 as a genetic counselor and educator for the grant-funded Mayo Eisenberg Genomics Education Program. During her time in Wisconsin, she was also an active member of the metabolic subcommittee of the state Newborn Screening Program and co-facilitated a phenylketonuria clinic.
At Mayo Clinic, she provides physician and staff education about clinically relevant topics in genomics. She also manages multiple education projects championed by Mayo Clinic physicians and is a faculty member for Mayo Medical School. In addition to her education roles, she sees adult patients in the Department of Medical Genetics.
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Genetics blog
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Oct. 24, 2008
Know your family history in assessing breast cancer risk
By Carrie A. Zabel, M.S., C.G.C.
Being that October is National Breast Cancer Awareness month, I decided to focus this week on assessing hereditary risk for breast cancer. Many people have a personal or family history of breast cancer and wonder how this will affect their future cancer risk or that of their family members. One of the keys to assessing your breast cancer risk is knowing your family history.
It's important to know that most breast cancer is not caused by a single gene predisposition, such as BRCA1 or BRCA2 (two genes widely publicized by the media). The majority of breast cancer is caused by the interaction of both genetic susceptibility factors and environmental factors; we call this multifactorial inheritance. There is no genetic testing available for families with multifactorial breast cancer yet, as the genes with a mild or moderate impact are not yet known, but research is focused on better understanding these families.
In the 10 percent of breast cancer which is thought to be caused by a single gene predisposition, or a strong genetic factor, red flags in an individual's personal or family medical history include:
- Early-onset breast cancer (before age 50)
- Ovarian cancer at any age
- Cancer in 2 or more close relatives
- Multiple or bilateral primary tumors
- Cancer appears to affect every generation
If you are concerned about your personal or medical family history, you can consider being further evaluated and educated by a genetic counselor. To locate one in your area, go to the National Society of Genetic Counselors Web site (see below) and click on the "Find a Counselor" link.
A genetic counselor will discuss your risk for breast cancer and your chance to have an underlying genetic alteration, such as a BRCA1 or BRCA2 mutation. They will also discuss the pros and cons of genetic testing, and what that means to you personally, as well as help facilitate testing, if you should desire.
Please share your experiences in this area.
5 comments posted
November 4, 2009 9:21 p.m.
my sister was diagnosed with breast cancer at 36 she died at 39 from this cancer. My mom also had breast cancer at 45. I am currently 37 and now my dad has stage III cancer we just found out. I'm just wondering why I can't get my insurance to cover a mammogram with so many (actually everyone) in my family having cancer. I do regular exams and I did find a lump a couple of years ago but it was only fibroid tumors. I would just like peace of mind and to be able to every few years get a mammogram. Also my nieces (daughters of my deceased sister) are still young I worry for them. hopefully be the time it is necessary for them to get mammograms ---insurances will wake up and allow preventative care.
- nikki
October 8, 2009 7:37 a.m.
I have set here this morning reading all I can. My grandmother died from breast cancer in 2001. Two weeks ago the doctor found a lump in my left breast, she doesn't believe its the typical shape for a cancerous lump. I went in for a recheck yesterday and well the lump is still there and she found the lymph nodes on my right swollen. I am 29 years old and she said they don't do mamograms on people my age ( cuz I requested one). She said sonograms only on people in my age range. Is this normal? Should I be looking into getting a second opinion? I have 3 kids under the age of 9, all were c-section babies, and were never breast fed. I always said after watching my grandmother suffer and battle cancer for all those years that if I got it I wouldn't fight it. But now I'm responceable for 3 kids and a WOUNDERFUL boyfriend, I have no choice, but to fight and win it. I dread the day that we find out its cancer. it absolutlely terrifies me!
- tammy
October 30, 2008 10:46 a.m.
I have 2 sisters and all 3 of us have had a breast cancer diagnosis. My older siser was age 50, I was also 50 at diagnosis, and our younger siser 54. Two of us have tested negative for genetic predisposition and the third sister has not yet had testing. There is no other family history of breast cancer that we are aware of. Nancy
- Nancy
October 26, 2008 8:56 p.m.
Both my grandmothers have had breast cancer (one before age 50, the other after), and my mother has also had it (age 54). Worries me a bit, though I'm not sure if the worry is justified. I'm currently 27, so only time will tell.
- Jill
October 26, 2008 8:40 a.m.
In 2000-2001, I and two of my first cousins suffered from various degrees of breast cancer. I had DCIS which was in two areas close to each other. I had a lumpectomy and radiation. I took Tamoxifen for 5 years. The two cousins are sisters. One had a radical mastectomy, radiation, chemo, and tamoxifen. The other, I am not sure how radical, or whether she had chemo, but she also had radiation and tamoxifen for 5 years. The former is the youngest, being under 60, and I and the other were (at the time)over 60. What my surgeon found as interesting was that we are cousins on both our mothers' and our fathers' sides of the family. As far as we know, there has not been breast cancer, on their mother's or my mother's sides of the family. We still are reminding all members of the family that mammograms are how our cancers were detected, and so far, we have not had any new cases. I do have a question, although I intend to check out that link. Both of my daughters have had breast implants. One has had an abortion, and now takes prednizone for asthma. She has two healthy pre-teen daughters. The other has had some heart arythmia problems during her pregnancies, but has two healthy children, one of them a girl. Fortunately I have a strong faith, and believe prayers can work. Thanks for reading my story.
- Joyce S.P.
5 comments posted