Genetic Counseling, Hereditary Cancer Risk Assessment, and Genetic Disease Risk Assessment

Northern Nevada Genetic Counseling (NNGC) is a private genetic counseling service.

"The National Society of Genetic Counselors (2005) defines genetic counseling as "the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. This process integrates:

  • Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence.
  • Education about inheritance, testing, management, prevention, resources and research.
  • Counseling to promote informed choices and adaptation to the risk or condition."

Genetic counselors are members of a health care team, providing information and support to individuals who have, or are at-risk for, an inherited condition, including hereditary cancer. They identify individuals/families at-risk, analyze inheritance patterns, interpret information about genetic disorders, assess risk of occurrence/recurrence, and review management options with the individual or family.

Genetic counselors work with clients to help them make decisions about how to manage their healthcare based on genetic risks. Genetic counseling is non-directive. The focus is on you and what you want.

I counsel about any hereditary disorder, but I specialize in hereditary cancer risk assessment.

• Understand Risks     • Identify Options     • Explore Solutions

Reasons (Or Indications) For Genetic Counseling

Hereditary Cancer Risk Assessment Genetic Counseling (HCRA) is appropriate for you if you have any of the following 'Red Flags' for hereditary cancer:

  • Multiple family members with cancer
  • Multiple cancers in one family member
  • Young age at diagnosis/onset of cancer (such as breast cancer before 50 years of age)
  • Cancer in both of paired organs (such as breast cancer in both breasts)
  • Rare or uncommon cancer, or cancer with unusual pathology (including male breast cancer, ovarian cancer, triple-negative breast cancer)
  • Jewish ancestry

I perform HCRA for Hereditary Breast and Ovarian Cancer associated with a mutation in the BRCA1, BRCA2, or other genes.

Other indications for you to have genetic counseling are:

  • You are interested in genetic testing, or want accurate interpretation of a genetic test result
  • You, or a family member, have a genetic/hereditary diagnosis, or you are concerned about a health condition that runs in your family
  • You, or a family member (including a previous child or fetus), have a history of a birth defect or a genetic/hereditary disorder
  • You, or a family member, have a chromosome (cytogenetic) abnormality/anomaly. Down Syndrome is an example of a chromosomal abnormality
  • You and your partner have a pregnancy that may be at risk for a genetic/hereditary condition
  • You have had two or more pregnancy losses (miscarriages,stillbirths)
  • You are related to your spouse/partner, and plan to have children together

Hereditary Cancer Risk Assessment:

It is estimated that 10% of all cancer is hereditary. There are many types of hereditary cancer (hereditary breast cancer, hereditary colon cancer, hereditary pancreatic cancer, etc.) Genetic testing is often available for hereditary cancer.

If your concern is about hereditary cancer, you need to complete and return a Family History Form. This form asks for information about your history and family history of cancer. Information is also obtained on family members without cancer. This information is needed for hereditary cancer risk assessment.

  • To download the Family History Form as a Microsoft Word document, click here.
  • To download the Family History Form as a .pdf file that can be filled out in Adobe Reader, click here.
    (If you don't have Adobe Reader, click here to download it free.)

Or you can contact me and I will mail you the form. You can print it, fill it out as best you can and return it to me. I will call you when I receive the completed form.

General Risk Assessment

Risk assessment is a prediction of health risks, or the estimate of the likelihood that you, or your children have, or will develop, symptoms of a genetic disorder. Risk assessment is based on:

  • Your medical history and your family medical history
  • Knowledge of the disorder that concerns you, including a review of current research
  • Diagnostic criteria for the disorder
  • Available models for estimating hereditary risk
  • An expert understanding of the complexities of genetics

Genetic Testing

Genetic testing can be empowering. With the advent of Next Generation Sequencing in the last couple of years, genetic testing has become very complicated. Often there are many laboratories that offer testing of several genes simultaneously in multi-gene panels. Interpretation of a result may be equivocal and not a straightforward 'positive' or 'negative.' For hereditary cancer genetic testing, the American College of Medical Genetics and Genomics and the National Comprehensive Cancer Network recommend genetic counseling by a genetics professional.

In our counseling appointment, we will discuss:

  • The availability of, and options for, genetic testing
  • The risks, benefits, and limitations of genetic testing
  • How the results of genetic testing may be beneficial to you
  • Your options for managing the hereditary disorder, if you have a positive (mutation identified) genetic test result
  • What genetic testing is most appropriate for you to consider.

The goal of genetic counseling is for you to be involved and make informed decisions about your health care management.

Genetic counseling does not inevitably lead to genetic testing. Genetic testing, if available, is your choice.

About Me

I am a 1990 American College of Medical Genetics and 1993 and 2007 American Board of Genetic Counseling certified genetic counselor, with more than 20 years experience in genetic counseling.

I received my genetic counseling training at the University of Cincinnnati in Ohio.

I have participated in the City of Hope (Duartre, CA) Intensive Course in Cancer Risk Assessment.

I have a Ph.D. in Developmental Biology. Before becoming a genetic counseler, I performed research in molecular genetics.

Genetic Counseling with Knowledge, Integrity, and Compassion


Our interaction depends upon your concerns around a genetic/hereditary condition.

A first step is usually a telephone conversation. During this conversation, you, or your healthcare provider, identify your concerns.

During our appointment, we briefly discuss general genetics; the hereditary contributions to the health condition that concerns you; the risk of the condition for you or your children; the options for managing this risk; your assessment of the magnitude of the risk; the availability of genetic testing; and information/resources or support services available to you. After the genetic counseling appointment you and your provider will receive a review letter of the appointment.

I am an 'in-network' provider for several insurance plans.

Contact Information

Phone / Fax:



(Emailing is not secured for the transmission of health information)

Mailing Address:

Robbin Palmer, Ph.D.
PO Box 10574
Reno, NV 89510-0574