Having Dense Breast Tissue
Breasts are made up of fatty tissue, fibrous tissue, and glandular tissue. Breasts appear denser on a mammogram when they have more glandular and fibrous tissue and less fatty tissue. Women with dense breasts on mammogram have a higher risk of breast cancer than women with average breast density. Unfortunately, dense breast tissue can also make it harder to see cancers on mammograms.
A number of factors can affect breast density, such as age, menopausal status, the use of certain drugs , pregnancy, and genetics.
To learn more, see our information on breast density and mammograms.
What Can You Do If You Are Concerned About Your Risk
If your doctor decides that your family health history makes you more likely to get breast, ovarian, and other cancers, he or she may refer you for genetic counseling. Even if your doctor doesnt recommend genetic testing and counseling, your family health history of breast cancer can affect when you start mammography screening. If you are a woman with a parent, sibling, or child with breast cancer, you are at higher risk for breast cancer. Based on current recommendationsExternalexternal icon, you should consider talking to your doctor about starting mammography screening in your 40s.
The genetic counselor can use your family health history information to determine your possible cancer risks and whether you might consider genetic testing to find out if you have a BRCA1, BRCA2, or other mutation. In some cases, the genetic counselor might recommend genetic testing using a panel that looks for mutations in several genes in addition to BRCA1 and BRCA2. Genetic testing is most useful if first performed on someone in your family who has had breast or ovarian cancer. If this relative has a BRCA1, BRCA2, or other mutation, then their close relatives can be offered testing for that mutation. If they do not have a BRCA1, BRCA2 or other mutation, then their relatives may not need to be tested. BRCA genetic counseling and testing is often, but not always, covered without cost sharing by many health plans under the Affordable Care Act.
Should I Avoid Getting Breast Implants Due To My Family History Of Breast Cancer
I am in my 50’s and my breasts are “sagging”. I do not want the scarring associated with a lift. Is there a problem with getting either a saline or silicone implants with regards to an increased breast cancer risk? Is it better in this case to go under the muscle? My mother developed breast cancer in her 70’s. Is that a reason I should not get implants?
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Some People Have A Significant Family History Of Breast Cancer
Sometimes, someones family history suggests they could be at increased risk of developing breast cancer.
This is known as having a significant family history.
This may be because theres an altered gene in their family that increases the risk of breast cancer.
Only about 510% of breast cancers are due to having inherited an altered gene.
Someone may be more likely to have a significant family history if two or more close relatives were diagnosed with breast cancer at a younger age, or if one relative has had breast cancer in both breasts.
Does Your Family Health History Put You At Risk
Collect your family health history of breast, ovarian, and other cancers and share this information with your doctor. You can inherit BRCA and other mutations from your mother or your father, so be sure to include information from both sides of your family. Include your close relatives: parents, sisters, brothers, children, grandparents, aunts, uncles, nieces, nephews, and grandchildren. If you have had breast, ovarian, or other cancers, make sure that your family members know about your diagnosis.
Tell your doctor if you have a personal or family health history of any of the following:
- Breast cancer, especially at a younger age
- Triple-negative breast cancer at age 60 or younger in women
- Cancer in both breasts
- Breast cancer in a male relative
- Ovarian, fallopian tube, or primary peritoneal cancer
- Pancreatic cancer
- Metastatic or high grade prostate cancer
- Breast, ovarian, pancreatic, or high grade prostate cancer among multiple blood relatives
- Ashkenazi or Eastern European Jewish ancestry
- A known BRCA or other cancer-related mutation in the family
You can use the My Family Health Portrait tool to collect your family health history information and share this information with your doctor and other family members. Update your family health history information on a regular basis and let your doctor know if any new cases of breast or ovarian cancer occur.
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The Risk Assessment Appointment
Try to find out as much about your family history as you can from other relatives before your appointment.
You may be asked to complete a questionnaire about your family history before being offered an appointment or you may be asked for this information at your appointment.
The nurse or genetic specialist looking at your family history will understand if you cannot find all the relevant information.
Having Radiation To Your Chest
Women who were treated with radiation therapy to the chest for another cancer when they were younger have a significantly higher risk for breast cancer. This risk depends on their age when they got radiation. The risk is highest for women who had radiation as a teen or young adult, when the breasts were still developing. Radiation treatment in older women does not seem to increase breast cancer risk.
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What Are The Risks Of Hrt For All Women
For the vast majority of women, the benefits from taking HRT outweigh any risks. The risks of HRT depend on the type you are given and also other factors such as your age and general health. Because there are different factors at play in determining an individuals risk of breast cancer, its so important to have a personalised consultation with your doctor to discuss your actual risks.
Many women worry about breast cancer when taking HRT, but most types of HRT do not actually increase the risk of breast cancer. Some studies have shown that women taking combined HRT containing both estrogen and a progestogen may be associated with The increased risk is related to the type of progestogen in the HRT and not the estrogen.
Taking micronised progesterone has not been shown to be associated with an increased risk of breast cancer. Even for women taking the synthetic progestogen, the risk is very low and is actually less than the increased risk of breast cancer associated with drinking a couple of glasses of wine each night, or from being overweight.
No studies have shown that any type of HRT increases the risk of a womans death from breast cancer. If you have had a hysterectomy in the past, and are just taking estrogen without a progestogen, you actually have a lower risk of breast cancer than if you did not take HRT at all.
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.
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Most Breast Cancers Are Not Inherited
Breast cancer is the most common cancer in women in the UK.
Most breast cancers are not inherited and only a small number of people have an increased risk of developing breast cancer because they have a significant family history.
If you have a relative with breast cancer, it doesnt necessarily mean youre more likely to develop it yourself.
Breast Cancer And Genetic Testing
At the current time, testing is available for BRCA gene mutations, as well as mutations ATM, CDH1, CHEK2, MRE11A, MSH6, NBN, PALB2, PMS2, PTEN, RAD50, RAD51C, SEC23B, and TP53, with this area expected to expand dramatically in the near future.
Having these tests available, however, raises many questions. For example, who might have hereditary breast cancer and who should be tested? What should you do if you test positive for one of these genes?
Ideally, any testing should be done only with the guidance and help of a genetic counselor. There are two reasons for this.
One is that it can be devastating to learn that you carry a mutation that may increase your risk, and the guidance of someone who is aware of recommended management and screening is invaluable.
As noted earlier, some mutations confer a high risk and others a much lower risk. Some mutations might be of more concern earlier in life , whereas others might not require early screening. A genetic counselor can help you learn about what is currently recommended with regard to screening for your particular mutation while taking into account any other risk factors you might have.
The other reason genetic counseling is so important is that you may have a significant risk of developing breast cancer even if your tests are negative. There is much yet to learn, and a genetic counselor can help you look at your family history to see if you may carry a high risk despite negative testing, and plan screening accordingly.
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Am I More At Risk If My Relatives Have Cancer
Some types of cancer can run in families. For example, your risks of developing certain types of breast cancer, bowel cancer or ovarian cancer are higher if you have close relatives who developed the condition.
This doesn’t mean you’ll definitely get cancer if some of your close family members have it, but that you may have an increased risk of developing certain cancers compared to other people.
It’s estimated that between 3 and 10 in every 100 cancers are associated with an inherited faulty gene.
Cancers caused by inherited faulty genes are much less common than those caused by other factors, such as ageing, smoking, being overweight and not exercising regularly, or not eating a healthy, balanced diet. Most cancers develop as a result of a combination of risk factors, which in some cases can include family history.
It’s only likely that a cancer gene is present in a family if:
- there are 2 or more close relatives on the same side of the family with the same type of cancer, or with particular types of cancer that are known to be linked for example, breast and ovarian cancer or bowel and womb cancer
- cancers are occurring at young ages
- a close relative has had 2 different types of cancer
Know The Signs Of Breast Cancer
Women with no family history of breast cancer should still be aware of their bodies and pay close attention to them. Breast tissues can start to feel lumpy, achy, and swollen. This may indicate that something isnt quite right.
These symptoms prompt women to visit a doctor instead of discovering another issue on their own like they might have in the past. Early detection leads to prevention and cost-saving on treatment centers if caught early enough.
Breast Cancer Without Family History: Basic Questions Answered
With a family history of breast cancer and no history of risk factors themselves, one may assume that they would be safe from the disease. Women usually take steps to keep their risk low by having regular mammograms and ultrasounds with doctors who specialize in diagnosing breast cancer.
However, hearing someone say that a woman has never had any risk factors or symptoms of breast cancer can be confusing or even alarming because there are many ways that it can occur without a family history.
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Genes Mutations And Cancer
Cancer is a disease in which cells grow out of control. This happens because of changes in some of the genes inside cells. Genes are pieces of DNA that control how cells make the proteins the body needs to function, as well as how cells are kept in balance. Your genes affect things such as hair color, eye color, and height. They can also affect your chance of getting certain diseases, such as cancer.
Nearly every cell in your body has all of the genes you were born with. Although all cells have the same genes, different cells may use different genes. For example, muscle cells use different genes than skin cells use. The genes that the cell doesnt need are turned off and not used. The genes that the cell is using are activated or turned on.
An abnormal change in a gene is called a mutation. Mutations in a gene can affect how it functions. For example, a mutation might stop a gene from working. Or it might keep a gene turned on all the time . Either way, these can cause problems inside the cell.
Gene mutations can be either inherited or acquired.
Many family cancer syndromes are caused by inherited mutations in tumor suppressor genes. These are genes that normally keep cells under control by slowing down how often they divide , repairing DNA mistakes, or telling cells to die at the right time.
For more information about gene changes that can lead to cancer, see Genes and Cancer.
Personal History Of Early Breast Cancer
Women diagnosed with invasive breast cancer are at a higher risk of developing cancer in their other breast.
There are also a number of non-invasive breast conditions that are associated with an increased risk of breast cancer. These include ductal carcinoma in situ , lobular carcinoma in situ and atypical ductal hyperplasia .
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Inherited Vs Acquired Gene Mutations
When talking about mutations, it’s important to distinguish between inherited and acquired gene mutations.
Acquired or somatic gene mutations have received a lot of attention in recent years, as these mutations cause changes that drive the growth of cancer. Targeted therapies, drugs that target specific pathways related to these changes, have significantly improved the treatment of some cancers such as lung cancer.
Acquired mutations, however, are not present from birth, but rather, are formed any time after birth in the process of a cell becoming a cancer cell. These mutations affect only some cells in the body. They are not inherited from a parent, but rather “acquired” as the DNA in cells is exposed to damage from the environment or as a result of the normal metabolic processes of the body.
Inherited, or germ-line mutations, in contrast, are genetic changes that people are born with, and that are passed down from one or both parents. These mutations affect all the cells of the body. It is these inherited mutations that can increase the chance that a person will develop cancer, and account for what is known as hereditary or familial breast cancer.
What Is A Family Cancer Clinic
If you feel you may be at high risk of developing breast cancer, you can talk to your doctor about referral to a family cancer clinic. There you will see a genetic counsellor, family cancer nurse, or specialist doctor trained in genetics. They will take a detailed family history to define your risk and discuss your options with you. They may arrange genetic testing and may discuss ways to reduce your risk of breast cancer.
Family cancer clinics also investigate family history of other cancers such as bowel cancer.
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Im Worried About My Family History Of Breast Cancer What Can I Do
If you are concerned about your risk of breast cancer and family history, you can visit your GP. They will be able to look at the patterns of cancers in your family to see whether you might be at an increased risk of breast cancer. If they think you might be, they will refer you to specialist services. Find out more about how genes affect our risk of developing breast cancer.
Being Overweight Or Obese
Overweight and obese women have a higher risk of being diagnosed with breast cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight also can increase the risk of the breast cancer coming back in women who have had the disease.
Fat tissue is the bodys main source of oestrogen after menopause, when the ovaries stop producing it. Having more fat tissue means having higher oestrogen levels, which may increase breast cancer risk.
Category : Moderately Increased Risk
Less than 4% of women are in this group.
Women in this group have a family history of breast cancer occurring in:
- One first-degree relative before the age of 50, or
- Two first-degree relatives on the same side of the family, or
- Two second-degree relatives on the same side of the family with at least one diagnosed under the age of 50
The risk of developing breast cancer in this group is moderately increased compared to that of the general population.
Referral For Further Assessment
Your GP may refer you to a specialist family history clinic or regional genetics centre, depending on where you live.
These are specialist services that can assess your individual risk of developing breast cancer.
Being referred for an assessment does not necessarily mean youre at an increased risk.
Find out more about the family history risk assessment process, including who should be referred.
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