What’s Your Risk Of Inheriting Breast Cancer
If one of your close relatives has been diagnosed with breast cancer, you may have concerns about whether breast cancer runs in the family .
A small number of people have an increased risk of breast cancer because of their family history. Knowing your genetic red flags that might increase your risk for inherited breast cancer is key and will help you decide if genetic testing is a good choice.
Inherited Cancer Gene Faults
Some faulty genes that increase the risk of cancer can be passed on from parent to child. These are inherited cancer gene faults. They occur when there is a fault in the genes in an egg or sperm cell at the time of conception. These faults in the initial sperm or egg cell are copied into every single cell in the body. The faulty genes can then pass from generation to generation. They are called germline mutations.
We inherit genes from both our parents. If a parent has a gene fault, then each child has a 1 in 2 chance of inheriting it. So, some children will have the faulty gene and an increased risk of developing cancer and some children wont.
Being born with inherited faulty genes doesnt mean that a person will definitely get cancer. But they have a higher risk of developing particular types of cancer than other people. They are also more likely to develop cancer at a younger age. Doctors call this having a genetic predisposition to cancer. For a cancer to develop, further gene changes need to happen. This usually happens over many years.
My Fathers Daughter: Family History & Early Detection In Both Prostate And Breast Cancer
Testing for cancer saves lives. I am proof.
Six years ago, at the beginning of October, I underwent my annual mammogram. A few days later there was a message on my answering machine that I needed to contact the imaging center for further testing. Later that month, I endured another mammogram, two ultrasounds, and an MRI, all which confirmed the initial radiologist finding: I had breast cancer.
I am not sure what scared me more: battling the disease or calling my father on the phone to let him know. I dont think most women would be scared to break the news to their father, to let him know that his daughter has breast cancer. However, it had nothing to do with me. My mother had died from breast cancer in 2007.
Family History of Cancer
I grew up in Colorado alongside my two sisters, parents and two sets of grandparents. In 1983, my senior year of high school, my paternal grandfather was in the hospital battling prostate and bone cancer. The cancer ultimately took his life.
This was the first time cancer had impacted my life in some way. When I was a kid no one ever talked about cancer. I cant even remember when I first learned the meaning of the word mammogram, the test that would eventually come to play such a big part in my life.
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Ovarian Cancer And Brca
- Most women in the UK have a one in 54 chance of developing ovarian cancer in their lifetime,
- BRCA1 and BRCA2 are genes that help repair damage to the DNA in our cells. If people inherit a mutated version of either of these genes it puts them at greater risk of certain cancers.
- BRCA 1 mutation gives women a lifetime risk of ovarian cancer of 40-50%.
- If women know they have BRCA gene mutations, they can choose to take action before cancer develops.
Does Breast Or Ovarian Cancer Run In Your Family
If you have close relatives with breast or ovarian cancer, you may be at higher risk for developing these diseases. Does your family health history put you at higher risk? Would you benefit from cancer genetic counseling and testing?
Each year, over 250,000 women in the United States are diagnosed with breast cancer and about about 20,000 are diagnosed with ovarian cancer. About 3% of breast cancers and 10% of ovarian cancers result from inherited mutations in the BRCA1 and BRCA2 genes that are passed on in families. Inherited mutations in other genes can also cause breast and ovarian cancer, but BRCA1 and BRCA2 are the genes most commonly affected. Although breast cancer is much more common in women, men with BRCA1 or BRCA2 mutations are more likely to get breast cancer than other men. BRCA mutations also increase the likelihood of getting pancreatic cancer and, in men, high grade prostate cancer. Knowing your family health history can help you find out if you could be more likely to develop breast, ovarian, and other cancers. If so, you can take steps to prevent cancer or to detect it earlier when it may be more treatable.
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How Do You Know If Pancreatic Cancer In Your Family Is Hereditary
If you are a first-degree relative of someone diagnosed with pancreatic cancer, you may have an increased risk of developing pancreatic cancer. Your family member with pancreatic cancer is strongly recommended to undergo genetic testing for inherited mutations.
- Negative results often mean you do not need to get genetic testing.
- If the results are positive, unknown or if you have several close family members with cancer, the Pancreatic Cancer Action Network recommends you consult with a genetic counselor to determine if you should get genetic testing for inherited cancer risk and if you should discuss options for monitoring.
The risk increases if more family members are affected with pancreatic cancer or other specific cancers or conditions, including:
- Familial breast, ovarian or colon cancer
- Familial melanoma
- Hereditary pancreatitis: repeating pancreatic inflammation, generally starting by age 20
- Inherited genetic syndromes associated with pancreatic cancer
Use our family history worksheet to better understand your risk of hereditary pancreatic cancer.
Being at higher risk or having a family history of pancreatic cancer does not mean that you will definitely get the disease.
Contact PanCANs PanCAN Patient Services to get more information about risk, to understand the different tests or for help finding a genetic counselor.
Does My Daughter Have An Increased Risk Of Breast Cancer
I am the mother of a healthy four-year-old daughter. My husband’s mother and one of her sisters have had breast cancer in their early 50s. As far as I know, neither my mother-in-law nor her sisters have been tested for the BRCA genes.
A few years ago, my mother mentioned genetic testing to my husband’s mother . My mother-in-law said in no uncertain terms that she did not understand why my mother thought this would be necessary, and the conversation was abruptly closed. My husband does not have a good relationship with his mother or aunts, and conversations beyond the quarterly catch-up phone calls tend to get heated, or lead to misunderstandings and complaints.
Should I broach the subject for my daughter’s sake or simply talk to her, when she is old enough to understand the importance of checks and explain that, because of the history of breast cancer on her paternal side, she should be particularly aware of disease and let her decide for herself whether to be tested in adulthood?
Is this a strong enough family history to justify her being tested now, while she is still a child? Or should my husband have a test to see if he has the gene before we decide whether our daughter should be tested?
G, via email
I spoke to Professor Nazneen Rahman, head of the cancer genetics clinical unit at the Royal Marsden Hospital, and it is with her input that I am replying to you.
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How Can Knowing About An Inherited Genetic Mutation Help Patients
Besides increasing risk for pancreatic cancer, some germline mutations affect treatment options for those who get the disease. Using the patients biology to figure out the best treatment options for a person is called precision medicine. Patients who receive treatment based on their biology can live longer.
As soon as possible after diagnosis, the Pancreatic Cancer Action Network strongly recommends all pancreatic cancer patients get genetic testing for inherited mutations and biomarker testing of their tumor tissue. These tests will help the healthcare team figure out the best treatment options for the patient and inform family members of risk.
Patients should discuss both tests with their care team. The tests can be available through their treating institution or PanCANs Know Your Tumor® precision medicine service.
Fathers May Pass Ovarian Cancer Risk To Daughters
US scientists believe they have identified a new gene mutation that can raise the risk of ovarian cancer, and is passed from father to daughter.
It is inherited through the X-chromosome and is independent of other known susceptibility genes that women can already be tested for.
Experts say more studies are needed to confirm the identity and function of the gene.
The latest findings appear in the journal PLoS Genetics.
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Predictive Genetic Tests For Cancer Risk Genes
Cancer is not usually inherited, but some types mainly breast, ovarian, colorectal and prostate cancer can be strongly influenced by genes and can run in families.
We all carry certain genes that are normally protective against cancer. These genes correct any DNA damage that naturally happens when cells divide.
Inheriting faulty versions or “variants” of these genes significantly raises your risk of developing cancer, because the altered genes cannot repair the damaged cells, which can build up and form a tumour.
BRCA1 and BRCA2 are examples of genes that raise your cancer risk if they become altered. Having a variant BRCA gene greatly increases a woman’s chance of developing breast cancer and ovarian cancer. They also increase a man’s chance of developing male breast cancer and prostate cancer.
BRCA genes are not the only cancer risk genes. Researchers recently identified more than 100 new gene variants associated with an increased risk of breast, prostate and ovarian cancer. Individually, these new gene variants only slightly increase the risk of cancer, but a combination could mean a high risk overall.
If you or your partner have a high-risk cancer gene, such as an altered version of BRCA1, it can be passed on to any children you have.
Hereditary Breast And Ovarian Cancer
About 5% to 10% of breast and 10% to 15% of ovarian cancers are hereditary. Hereditary cancer means cancer runs in your family, and could be caused by a change in certain genes that you inherited from your mother or father.
Genes act as instructions and contain information to build and maintain cells in the body. Humans inherit one set of genes from their mother and one set of genes from their father.
Genes are made up of DNA. DNA tells the body what traits will be passed on from parents to children, such as blood type, hair color, eye color, and risks of getting certain diseases.
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What Are Brca1 And Brca2 Genes
Your genetic make-up comes from your genes and your environment, which can also affect your cancer risk.
Genes are passed from parent to child and define how we look and how our body functions. The BReast CAncer susceptibility gene are genes in our body that slow down cancer growth by repairing damaged genetic material .
However, if these genes are altered through a mutation the DNA damage may not be repaired. Cancer cells can grow more easily with mutations in either the BRCA1 or BRCA2 genes. Mutated BRCA genes can be inherited from mother, father, or both parents.
Women with a mutation in the BRCA1 or BRCA2 gene have a higher risk of developing breast cancer and ovarian cancer. There is also a smaller risk of developing other cancers due to this mutation in women, such as fallopian tube cancers, peritoneal, colon and pancreatic cancers.
Men may also have BRCA mutations and are at higher risk for breast cancer, prostate cancer, and pancreatic cancer.
What Is A Genetic Counselor
Genetic counselors are trained in the medical and emotional aspects of inherited diseases. An oncology genetic counselor specializes in counseling and educating people with cancer and their family members who may have a higher chance of developing cancer.
Learn more about genetic counseling.
A genetic counselor can also help you and your family decide if you should get genetic testing.
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How Common Is Hboc
Most breast and ovarian cancers are sporadic, meaning they occur by chance with no known cause. Most women who have breast or ovarian cancer do not have HBOC.
Currently, it is estimated that less than 1% of the general population has a mutation in the BRCA1 or BRCA2 genes, and up to 10% of women and 20% of men diagnosed with breast cancer have a mutation in 1 of these genes. About 10% to 30% of women younger than 60 diagnosed with triple-negative breast cancer, which are cancers that do not have receptors for estrogen, progesterone, and HER2, have a BRCA1 or BRCA2 gene mutation, and others will have mutations in other breast cancer risk genes. Therefore, doctors recommend that women with triple-negative breast cancer receive genetic counseling and genetic testing .
HBOC is most common in families who have had multiple cases of breast cancer and/or ovarian cancer on the same side of the family. In families with 4 or more cases of breast cancer diagnosed before age 60, the chance of HBOC is about 80%. To compare, the chance of finding HBOC when only 1 woman has had breast cancer diagnosed before age 50 is estimated to be 10% or less.
Families with Ashkenazi Jewish ancestry have an increased chance of having HBOC. There are 3 specific gene mutations, known as founder mutations, that are common in these families:
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185delAG in BRCA1
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5382insC in BRCA1
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6174delT in BRCA2
What Is A Genetic Registry
Genetic or family registries collect information about families with multiple pancreatic cancer diagnoses. This often includes information about a familys:
- Environment
- History of pancreatic cancer
- Incidence of other cancers in the family
The goal is to find common aspects in families with multiple pancreatic cancer cases that will lead to better understanding of the disease. Registries are vital to research on hereditary pancreatic cancer causes.
Family registries do not offer tests or screening for early detection of pancreatic cancer.
If you have been diagnosed or have taken care of someone diagnosed with pancreatic cancer and would like to contribute to research, join our Patient Registry.
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Cancer Risks For Womenwith Brca1/brca2 Mutations
Women who inherit a mutation in the BRCA1 or BRCA2 gene have a much higher risk of developing breast and ovarian cancer. But, important steps can be taken to help lower the risk for cancer in these women. Its important to know that not everyone who inherits a BRCA1 or BRCA2 mutation will get breast or ovarian cancer, and that not all inherited forms of breast or ovarian cancer are due to mutations in BRCA1 and BRCA2.
Who Should Consider Genetic Counseling And Testing For Brca1 And Brca2 Variants
Anyone who is concerned about the possibility that they may have a harmful variant in the BRCA1 or BRCA2 gene should discuss their concerns with their health care provider or a genetic counselor.
Tests are available to see if someone has inherited a harmful variant in BRCA1 and BRCA2. However, testing is not currently recommended for the general public. Instead, expert groups recommend that testing be focused on those who have a higher likelihood of carrying a harmful BRCA1 or BRCA2 variant, such as those who have a family history of certain cancers. Testing can be appropriate for both people without cancer as well as people who have been diagnosed with cancer. If someone knows they have a mutation in one of these genes, they can take steps to reduce their risk or detect cancer early. And if they have cancer, the information about their mutation may be important for selecting treatment.
Before testing is done, a person will usually have a risk assessment, in which they meet with a genetic counselor or other health care provider to review factors such as which of their relatives had cancer, what cancers they had, and at what ages they were diagnosed. If this assessment suggests that someone has an increased risk of carrying a harmful BRCA1 or BRCA2 gene variant, their genetic counselor can discuss the benefits and harms of testing with them and order the appropriate genetic test, if the individual decides to have genetic testing .
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What Is Genetic Testing
Genetic testing looks for inherited mutations. The alterations to a persons DNA are the same throughout their whole body. So, this analysis is usually done on a blood or saliva sample.
All people diagnosed with pancreatic cancer, regardless of family history, should have genetic testing to help with treatment decisions. If genetic testing shows a germline mutation, then their loved ones could consider getting tested also.
Carriers of a genetic alteration are at higher risk than most people. But this does not mean that they will definitely develop the disease.
Genetic tests can be expensive. Insurance may cover the testing, but not always. Genetic counselors can help by telling your insurance company the importance of genetic counseling and having the testing covered for you.
Talk to your doctor or a genetic counselor to choose the tests and next steps that are right for you.