What role do genes play in breast cancer?
Knowing your family history helps you understand your risk for breast cancer. Every living being has a genetic code, a combination of their parents’ genes, which makes them unique. Mutations (changes) in certain genes can make it more likely for cells to become cancerous. Specific mutations of the BRCA1 and BRCA2 genes are linked to breast, ovarian and other types of cancer.
Should everyone be tested for the BRCA1 and BRCA2 genes?
No, not everyone needs to be tested. Your family medical history is a good indicator of whether you have the gene mutation. WHO in your family had breast or ovarian cancer and their AGE at diagnosis are important. Try to get histories for three generations before you. Having ovarian cancer, at any age, raises the question of a genetic mutation. Other conditions possibly linked with genetic mutations include cancers of the pancreas, thyroid, colon, bones and soft tissue as well as melanoma. The BRCA gene mutations are also more prevalent in people with Ashkenazi Jewish ancestry. Sometimes women are concerned about their risks if a female relative had breast cancer after menopause. Commonly, this history does not increase breast cancer risk and does not imply a genetic mutation, but it is still important to record. Also, cervical, endometrial and uterine cancers are important to keep track of but are rarely suggestive of a genetic mutation.
At what age should a woman think about her genetic risk for breast cancer?
At age 18, when a person becomes a legal adult, is the earliest age to consider breast cancer risk. See your doctor
to discuss your details including your ethnicity, whether you’ve had any cancers and your family history. If your doctor
believes it’s indicated, the next step is to talk to a genetic counselor about testing—a simple mouth swab or blood
test. Older women, who have survived ovarian or breast cancer, may consider having genetic testing to make other
relatives and younger generations aware of whether or not a genetic mutation exists.
What if I have the BRCA1 or BRCA2 mutation?
Finding the genetic mutation is very rare, but if it is present, there are ways to reduce your cancer risks. The priority
is eliminating the risk for ovarian cancer because it doesn’t produce symptoms until it is very advanced. For women
who are through childbearing, removal of the ovaries and fallopian tubes is very effective—reducing your risks
for ovarian cancer by 90 percent and for breast cancer by 50 percent. To reduce the risk of breast cancer,
closely managed screenings, every six months, are very effective as is the use of certain medications.
Preventive mastectomy reduces the risk by 95 percent.
If I test negative for the genes, or there’s no family history, do I even have to think about breast cancer?
Genetic mutations are responsible for just five percent of all breast cancer cases. There are other risk factors
that can lead to the condition—age at menses, age at first childbirth, weight, and lifestyle are all factors. The majority
of doctors in our nation agree that the best way for women, who do not have a family history, to detect breast cancer
at its earliest stage is through annual mammograms beginning at age 40.