What Do I Ask The Doctor
Visiting the doctor can be stressful. It helps to have questions written down ahead of time. Print these questions and take them with you when you visit the doctor. You may also want to ask a family member or close friend to go with you to take notes.
- What is my risk of developing breast or ovarian cancer?
- Are there warning signs I can look out for?
- Based on my health history and my family history, would you recommend genetic testing to learn more about my risk?
- What are the benefits and risks of genetic testing?
- What are my chances of having a mutated gene that could increase my risk for cancer?
- What would a positive or negative test result mean for me?
- If I have a mutated gene, what are my options for managing my risk?
- If I have a mutated gene, what would it mean for my children’s health?
- If I have a mutated gene, what does that mean for other members of my family?
- If I get geneting testing, who will be able to see my test results?
- Besides mutated genes, what other things increase my risk for breast and ovarian cancer?
- If I decide not to do genetic testing, what types of cancer screening tests are recommended to check for breast and ovarian cancer?
- Is there information I can take with me about genetic testing?
Common Symptoms Of Male Breast Cancer What To Look Out For
The most common symptom of breast cancer in men is a firm lump in the breast tissue deep to the nipple. This is nearly always painless and other symptoms may include:
- Oozing from the nipple that may be blood stained.
- Swelling of the breast.
- A sore in the skin of the breast.
- A nipple that is pulled into the breast .
- Lumps under the arm.
If you are showing any of the common symptoms listed above, please call us onto book a OneStop Breast Clinic appointment.
Were pleased to cancel and re-schedule any appointments without penalty or administration fees up to 24 hours before your appointment. However, with less than 24 hours notice of cancellation, re-scheduling or non-attendance on the day does incur a 100% cancellation fee as well be unable to re-use the time to support other clients. New appointments will be charged at the self-pay rate of £250 .
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Talking To Your Family
If your test shows that you have a faulty inherited gene, some members of your family may also be at risk of having that gene. They may also need to have testing. It is helpful to think through how you would feel about this and what it would mean for them.
It is worth thinking about who you might need to tell once you know the result. Talking to your genetic counsellor can help you to work this out.
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Who Should Consider Genetic Counseling And Testing For Brca1 And Brca2 Variants
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 .
Cost Of Genetic Testing To Guide Breast Cancer Treatment
If your health care provider recommends genetic testing to help guide your breast cancer treatment, insurance usually covers the cost. However, its best to check with your health insurance company to find out whether genetic testing costs are covered in your plan.
Your health care provider or a genetic counselor can help you determine if your insurance will cover genetic testing.
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Learning About Your Family Background
If you or any of your family members have had breast cancer, you may be a candidate for genetic testing. The best way to get started is to learn more about your family history on your mothers and fathers sides. An abnormal gene that increases breast cancer risk is more likely to run in your family if:
your family is of Ashkenazi Jewish descent
You may be interested in meeting with a genetic counselor a medical professional specially trained to understand and provide information about genetics and disease. A genetic counselor works with you to build a family tree that shows all cases of breast, ovarian, and other types of cancer in your family, along with the ages at which they occurred. This visual history can help you determine whether or not genetic testing makes sense for you. Before you can build this family tree, however, you may need to do some research.
As you identify possible cases of breast cancer or ovarian cancer in your family, try to confirm them with medical records and a pathology report whenever possible.
For example, if one of your aunts died of liver cancer, its important to find out whether she was diagnosed with breast cancer that spread to the liver or with cancer that actually started in the liver. If your grandmother was diagnosed with stomach cancer, further investigation may show that it was really ovarian cancer that spread inside the abdomen, affecting her stomach.
When Is Genetic Testing Not Recommended
Theres only a very small chance your family carries a BRCA1/2 inherited gene mutation if you or a family member is the only person in your family with breast cancer .
Although you always have the option of being tested, in most cases, genetic testing isnt recommended when theres a very low chance of finding a mutation. Its strongly recommended you speak with a genetic counselor before deciding whether to have genetic testing.
Most breast cancers are not due to a BRCA1/2 or other inherited gene mutation linked to breast cancer .
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Benefits Of Genetic Testing For Inherited Gene Mutations Related To Breast Cancer Risk
Genetic testing may give you information about your risk of developing another cancer, such as ovarian cancer or prostate cancer .
It may also help your family members better understand their risk of breast cancer and other cancers, such as ovarian cancer or prostate cancer. In some cases, genetic testing may help tailor their cancer screening.
Talk with your health care provider or a genetic counselor about whether it would be useful to have genetic testing.
Risk Factors For Hereditary Cancer
A hereditary cancer is any cancer caused by an inherited gene mutation. An inherited gene means it is passed from parent to child within a family. The following factors suggest a possible increased risk for hereditary cancer:
Family history of cancer. Having 3 or more relatives on the same side of the family with the same or related forms of cancer.
Cancer at an early age. Having 2 or more relatives diagnosed with cancer at an early age. This factor may differ depending on the type of cancer.
Multiple cancers. When one relative develops 2 or more types of cancer.
Rare cancers. Some types of cancer, such as ovarian cancer, adrenocortical cancer, or sarcoma, are linked to inherited genetic mutations.
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Breast Cancer Risk Reduction Guidelines For People With High
If you have a BRCA1/2 inherited gene mutation, there are options to help lower your risk. Discuss these options with your health care provider.
Women with certain other high-risk gene mutations may also consider risk-lowering drugs or preventive surgery to lower their risk of breast cancer. However, risk reduction guidelines for women with other high-risk gene mutations are less clear than those for women with BRCA1/2 mutations. As more is learned about these mutations, guidelines can be more personalized.
Whether or not you have a gene mutation related to breast cancer, there are things you can do to help lower your risk.
If you have a BRCA1/2 inherited gene mutation, talk with your health care provider about the pros and cons of these options.
There are risk reduction guidelines for women with some of the other high-risk gene mutations. However, these guidelines may be less clear than those for women with BRCA1/2 mutations. As more is learned about these mutations, guidelines can be more personalized.
If you have a high-risk gene mutation, talk with your health care provider about whether a risk-lowering drug or preventive surgery may be an option for you.
Take your time. Dont feel you need to rush to make a decision.
Learn more about options for women at high risk.
How Can A Person Who Has Inherited A Harmful Brca1 Or Brca2 Gene Variant Reduce Their Risk Of Cancer
Several options are available for reducing cancer risk in individuals who have inherited a harmful BRCA1 or BRCA2 variant. These include enhanced screening, risk-reducing surgery , and chemoprevention.
Enhanced screening. Some women who test positive for harmful BRCA1 and BRCA2 variants may choose to start breast cancer screening at younger ages, have more frequent screening than is recommended for women with an average risk of breast cancer, or have screening with magnetic resonance imaging in addition to mammography.
No effective ovarian cancer screening methods are known. Some groups recommend transvaginal ultrasound, blood tests for the CA-125 antigen , and clinical examinations for ovarian cancer screening in women with harmful BRCA1 or BRCA2 variants. However, none of these methods appear to detect ovarian tumors at an early enough stage to improve long-term survival .
The benefits of screening men who carry harmful variants in BRCA1 or BRCA2 for breast and other cancers are not known. Some expert groups recommend that such men undergo regular annual clinical breast exams starting at age 35 . The National Comprehensive Cancer Network guidelines recommend that men with harmful germline variants in BRCA1 or BRCA2 consider having a discussion with their doctor about prostate-specific antigen testing for prostate cancer screening starting at age 40 .
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If You Were Diagnosed With Breast Cancer In The Past
If you were diagnosed with breast cancer in the past and were only tested for BRCA1/2 inherited gene mutations , the NCCN recommends you consider expanded panel testing.
Testing may give you information about your risk of developing another cancer.
Panel testing may also help your family members better understand their risk of breast cancer and other cancers. In some cases, panel testing may help tailor their cancer screening.
In most cases, genetic testing results wont likely impact your breast cancer treatment or follow-up care. However, people with metastatic breast cancer who have a BRCA1/2 gene mutation may have a PARP inhibitor drug included in their treatment plan .
Talk with your health care provider or a genetic counselor about whether it would be useful to have panel testing.
Genetic Testing Facilities And Costs
You can get a genetic test in your doctors office to see if you have inherited an abnormal BRCA1, BRCA2, or PALB2 gene mutation. The doctor takes a blood or saliva sample and sends it to a commercial laboratory, or sometimes a research testing facility. During testing, the genes are separated from the rest of the DNA and scanned for abnormalities.
Whether the genetic test is handled by a research testing facility depends on the type of test and the specific genes being tested. Research laboratories tend to perform free and anonymous tests. But research laboratories may provide limited results or require multiple family members to participate. It also may take many months or years for test results to be ready, if they are ever made available at all.
In the United States, several laboratories conduct commercial BRCA1, BRCA2, and PALB2 testing, including Myriad Genetic Laboratories, Ambry Genetics, and GeneDx. These facilities report results in two to four weeks.
The most common causes of hereditary breast cancer are BRCA1 and BRCA2 mutations. But abnormalities in other genes also have been associated with breast cancer risk.
Although many insurance plans cover genetic testing, its smart to confirm whether your insurance plan does.
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Should I Get Tested For The Breast Cancer Gene
- Should I get tested for the breast cancer gene?
I cannot thank Angelina Jolie enough for going public with her decision to have a double mastectomy after discovering she carries the BRCA1 gene. I can only hope that greater awareness helps us to identify women at greatest risk for breast and ovarian cancer. However, I do want to use this forum to provide some more information about who should get tested for the gene.
The CNN piece discusses Jolies personal decision to have a double mastectomy. We learn that Jolies mother died of ovarian cancer in her 50s. Knowing this part of Jolies family history, her healthcare provider likely suggested she be tested for the BRCA gene. When she discovered she was positive for the BRCA1 gene, she was likely counseled on her increased risk for ovarian and breast cancer. In consideration of her increased risk for breast cancer, she decided to have a double mastectomy. The story makes most people wonder should I get tested too?
What does this mean
*The majority of people who get breast and ovarian cancer do not carry the gene. This is important to understand BRCA1 and BRCA2 carriers are at significantly higher risk for developing breast cancer in contrast to the general population. But, if you are not a BRCA1/2 carrier it does not mean you will never get breast cancer. It is important to keep up with your yearly clinical breast exams and regular mammograms even if you do not carry the gene.
What Are The Benefits Of Genetic Testing
For some women, genetic testing may help you make informed medical and lifestyle decisions while easing the anxiety of not knowing their genetic background. You can also make a decision regarding prevention, with both medications and prophylactic surgery. In addition, many women take part in medical research that, in the long run, may lower their risk of death from breast cancer.
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Where Can I Go To Get Screened
You can get screened for breast cancer at a clinic, hospital, or doctors office. If you want to be screened for breast cancer, call your doctors office. They can help you schedule an appointment.
Most health insurance plans are required to cover screening mammograms every one to two years for women beginning at age 40 with no out-of-pocket cost .
Are you worried about the cost? CDC offers free or low-cost mammograms. Find out if you qualify.
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How Accurate Is Genetic Testing For Breast Cancer
Generally speaking, genetic testing is quite accurate at detecting known genetic variants. But these tests cannot tell you whether youll eventually develop breast cancer.
Receiving a positive result means that, compared to the general population, youre at an increased risk of developing breast cancer. Different gene variations can be linked to different levels of risk.
A positive result doesnt mean that youre certain to get breast cancer in the future. In fact, its possible youll never develop breast cancer. Your genetic counselor can give you a better idea of your breast cancer risk.
Similarly, a negative result doesnt mean that youll never develop breast cancer.
Tests dont always cover a broad range of gene variations. Its possible that you may have a harmful variation that wasnt covered by your test.
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Genetic Counseling And Testing For Breast Cancer Risk
Some people inherit changes in certain genes that increase their risk of breast cancer . Genetic testing can look for mutations in some of these genes. While it can be helpful in some cases, not everyone needs to be tested, and each person should carefully consider the pros and cons of testing. Its very important to understand what genetic testing can and cant tell you before these tests are done.
Is There Anything Else I Need To Know About A Brca Genetic Test
If your results show you have a BRCA gene mutation, you can take steps that may lower your risk of breast cancer. These include:
- More frequent cancer screening tests, such as mammograms and ultrasounds. Cancer is easier to treat when it’s found in the early stages.
- Taking birth control pills for a limited time. Taking birth control pills for a maximum of five years has been shown to reduce the risk of ovarian cancer in some women with BRCA gene mutations. Taking the pills for more than five years to reduce cancer is not recommended. If you were taking birth control pills before you took the BRCA test, tell your health care provider how old you were when you started taking the pills and for how long. He or she will then recommend whether or not you should continue taking them.
- Taking cancer-fighting medicines. Certain drugs, such as one called tamoxifen, have been shown to reduce the risk in women with a higher risk of breast cancer.
- Having surgery, known as a preventive mastectomy, to remove healthy breast tissue. Preventive mastectomy has been shown to reduce breast cancer risk by as much as 90 percent in women with a BRCA gene mutation. But this is a major operation, only recommended for women at very high risk for getting cancer.
You should talk with your health care provider to see what steps are best for you.
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