Knowledge Is Power And We Can Be Powerful Together
Your greatest asset in the fight against breast/ovarian cancer is knowledge of both the scientific facts and your own biology. This includes being educated on HBOC and the intrinsic link between breast and ovarian cancer. If caught and treated early, ovarian cancer patients 5-year survival rate is 92%. However, only 20% of cases are actually diagnosed this early. We need to change this. Please share this article with friends and family members. Keep up with us on social media for helpful tips, inclusive events, and up-to-date facts.
Higher Risk in the Ashkenazi Jewish Population
Why is the Ashkenazi Jewish population at higher risk?
- Breast cancer
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If the DNA sequence is changed, like a spelling mistake, the instructions may not make sense. The technical term for this change is mutation, meaning there is a change to the usual genetic code that may change the instructions stored in the gene. A mutation in a gene that repairs DNA damage or controls cell growth can increase the risk of developing cancer.
Sporadic vs Hereditary Cancers:
BRCA 1 and BRCA 2: Most Common hereditary breast and ovarian cancer
Genetic Tests For Hereditary Cancer Syndromes
Genetic tests for mutations that cause hereditary cancer syndromes are usually requested by a persons doctor or other health care provider. Genetic counseling can help people consider the risks, benefits, and limitations of genetic testing in their particular situations.
A genetic counselor, doctor, or other health care professional trained in genetics can help an individual or family understand their test results and explain the possible implications of test results for other family members.
People considering genetic testing should understand that their results may become known to other people or organizations that have legitimate, legal access to their medical records, such as their insurance company or employer, if their employer provides the patients health insurance as a benefit. Legal protections are in place to prevent genetic discrimination, including the Genetic Information Nondiscrimination Act of 2008 and the Privacy Rule of the Health Information Portability and Accountability Act of 1996.
The page on Genetic Testing for Inherited Cancer Susceptibility Syndromes has more information on what tests are available and who may want to consider them.
Considering Genetic Counseling And Testing For Breast Cancer Risk
If you have breast cancer or a family history of breast cancer, talk with your doctor. As a first step, your doctor might use one of several risk assessment tools that are now available. These mathematical models use your family history and other factors to help give you and your doctor a better idea about your risk of having a BRCA mutation. But the tools aren’t perfect, and each one might give different results, so doctors are still trying to figure out how best to use them.
Regardless of whether or not one of these tools is used, your doctor might suggest you could benefit from speaking with a genetic counselor or other health professional who is trained in genetic counseling. They can review your family history in detail to see how likely it is that you have a family cancer syndrome such as HBOC. The counselor can also describe genetic testing to you and explain what the tests might be able to tell you, which can help you decide if genetic testing is right for you.
Its very important to understand what genetic testing can and cant tell you, and to carefully weigh the benefits and risks of genetic testing before these tests are done. Testing can cost a lot, and it might not be covered by some health insurance plans.
If you do decide to get tested, the genetic counselor can also help explain what the results mean, both for you and possibly other family members. To learn more about genetic testing in general, see Genetics and Cancer.
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What To Do If You’re Worried
Speak to a GP if cancer runs in your family and you’re worried you may get it too. They may refer you to a local genetics service for an NHS genetic test, which will tell you if you have inherited one of the cancer risk genes.
This type of testing is known as predictive genetic testing. It’s “predictive” because a positive result means you have a greatly increased risk of developing cancer. It does not mean you have cancer or are definitely going to develop it.
You may be eligible for this NHS test if the faulty gene has already been identified in one of your relatives, or if there is a strong family history of cancer in your family.
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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Who Gets Breast Cancer The Most
Being a woman and getting older are the main risk factors for breast cancer. Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.
What If I Dont Have A Strong Family History
After looking at your family history, the genetic doctor might tell you that its unlikely that you have an inherited faulty gene. In this case, your risk of cancer is the same as other members of the population.
In certain situations, the genetic counsellor might suggest you have regular screening. This is more likely if members of your family have breast or bowel cancer.
You can find out about this in our information about:
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Important Facts About Breast Cancer
1. Breast cancer is the most common form of cancer in women. Over 70,000 women develop breast cancer in Germany every year.
2. Men can also develop breast cancer. Every year 600 to 700 men in Germany are diagnosed with breast cancer.
3. Almost half of all breast cancer diagnoses are made in women between the ages of 50 and 69 years . Thats why women are invited to mammograms every two years during this period.
4. Age is a risk factor: just under every fifth breast cancer diagnosis is made in women who are younger than 50 years old.
5. From the age of 70, a womans risk of developing breast cancer decreases again.
6. The cure rate for breast cancer has improved significantly in the past few decades: from 50 to 60 percent in the 50s and 60s to 75 to 80 percent today.
7. Despite the good chances of recovery, over 17,000 women in Germany still die of breast cancer every year.
8. Around 30% of all women with breast cancer in Germany have a familial history of breast cancer and can have an examination for breast cancer genes carried out.
9. There are several genes that, if altered, can cause breast and ovarian cancer. The genes BRCA1 and BRCA2 are known and researched.
10. Changes in the breast cancer genes BRCA1 and BRCA2 can be detected in around 5 out of 100 women .
11. 60 out of 100 women with an altered BRCA1 gene will develop breast cancer by the age of 70.
12. 55 out of 100 women with an altered BRCA2 gene will develop breast cancer by the age of 70.
How To Know If You Have Breast Cancer
This article was medically reviewed by . Dr. Litza is a board certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.There are 24 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 100% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 574,587 times.
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Brca1 Mutation Carriers Have Higher Chances For More Aggressive Breast Cancer
60% to 80% of women with the BRCA1 mutation have triple-negative breast cancer. Triple-negative means that the three most common types of receptors known to fuel most breast cancer growth are not present in the cancer tumor.
Its considered to be more aggressive and has a poorer prognosis than other types of breast cancer, mainly because there are fewer targeted medicines for treating triple-negative breast cancer.
It seems to be more common among younger women. Because its also more common in women with BRCA1 gene mutation, experts recommend that patients with triple-negative breast cancer younger than 60 get genetic counseling.
Guidelines For Elective Surgical Options
Women with BRCA1 or BRCA2 mutations face a significant risk of breast and ovarian cancer. Prophylactic removal of the fallopian tubes and ovaries is recommended by about age 40. Many women with BRCA1 or BRCA2 mutations will also elect to have their breasts removed. Nipple-sparing mastectomy is an effective option for these women.
Making the decision to have an elective preventive double mastectomy and removal of the ovaries is personal and should be based on many life factors. You must balance where you are in your childbearing years, what your future choices may be, and whether you would prefer to follow a rigorous screening schedule instead of making such a life-altering choice.
Whatever your decision, we encourage you to make an informed choice. If you do elect to have a preventive double mastectomy, our breast specialists will guide you in the appropriate breast surgery reconstruction to help restore your body image after treatment.
If you are interested in discussing ovary removal surgery , we will refer you to one of our gynecological oncologists.
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What Is My Risk Of Developing Breast Cancer
All women in the US, regardless of family history, have a minimum 1:8 or 12.5% risk of developing breast cancer in their lifetime.
Of those that do, 5-10% are considered to be heritable, or strongly related to inheriting a known harmful genetic mutation in a breast cancer predisposition gene. 15-20% are considered to be familial, or family history shows multiple affected family members in multiple generations, but genetic testing is negative for a known breast cancer associated genetic mutation. Meanwhile, 75-80% are considered sporadic, or most likely due to a combination of many factors non-modifiable and modifiable.
If you have many of the non-modifiable and modifiable risk factors discussed in my previous blog post, your risk is likely more than 12.5%.
Know Your Family History Of Breast Cancer
It is very important to know your family history as it strongly informs your personal risk of developing breast cancer.
You should be proactive in obtaining this information while family members are still alive. The information you should try to learn includes:
- Who in your family has had cancer?
- How old were they when they were diagnosed?
- Did they die from the cancer and if so, at what age?
- What kind of cancer did they have?
- If they had breast cancer, was it hormone sensitive ?
- Was it HER2 positive or negative?
- How was it treated?
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Brca Mutation Means An Increased Risk Of Developing Breast Cancer At A Young Age
Carriers of the BRCA1 mutation have a greater risk of developing breast cancer before they reach 40 years, compared to carriers of the BRCA2 mutation. Over the age of 55 women who carry the BRCA2 mutation remain at higher risk of developing breast cancer and women carrying the BRCA1 mutation have a lesser risk.
How Much Does Genetic Testing For Breast Cancer Cost
The cost of genetic testing for breast cancer risk varies based on the extent of the testing. Testing for common harmful variants in BRCA1 and BRCA2 may be less expensive than a test that looks at multiple genes.
Genetic testing for breast cancer risk can cost anywhere between $300 to $5,000. Ask a healthcare professional or genetic counselor about whats included in a test and how much it will cost.
Many health insurance plans will cover genetic testing if its determined to be medically necessary. Its important to check with your insurance provider about whats covered beforehand.
Here are the next steps you should take depending on whether youre deciding to take a genetic test or have already received results.
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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 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.
Genetic Testing For Breast/ovarian Cancer Risk
It is possible to detect mutations in some cancer predisposing genes. Some mutations may not be detected using current technology.
Genetic testing involves first searching for a gene mutation. The genes most commonly tested are BRCA1 and BRCA2. After genetic counselling, a sample of blood is usually taken from a woman in the family who has developed breast cancer or ovarian cancer. The DNA is searched for a gene fault. This testing may take some months.
If a gene fault is not detected after a mutation search, then testing for the family should be considered as inconclusive. However, if a fault is detected, then other family members can be tested to see if they carry the same gene fault or not. The testing for other family members is known as predictive genetic testing. This is a relatively quick test since the laboratory only has to determine the presence or absence of the family gene mutation in a predictive test.
Genetic testing is offered only through a family cancer clinic. If a woman is referred to a family cancer clinic, the availability, limitations, potential benefits, and possible consequences of genetic testing will be discussed with her.
*In July 2011, National Breast and Ovarian Cancer Centre amalgamated with Cancer Australia to form a single national agency, Cancer Australia, to provide leadership in cancer control and improve outcomes for Australians affected by cancer.
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What Is A Gene
Each persons DNA contains the code used to build the human body and keep it functioning. Genes are the small sections of DNA that code for individual traits. For example, someone with naturally red hair has a gene that causes his or her hair to be red.
All inherited traits are passed down through genes. Each person has two copies of every gene: one gene from each parent. Since each parent passes down exactly half of their genes to each child, any of the parents genetic traits has a 50% chance of being passed on to their offspring.
Who Should Be Tested For Hboc
Most breast and ovarian cancers occur by chance with no known cause, so testing for BRCA1 or BRCA2 gene mutations may not be beneficial for the average person. Genetic testing is recommended primarily for people who have a personal and/or family history that suggests HBOC. However, women younger than 60 with triple-negative breast cancer , are at risk of having a BRCA mutation, regardless of family history.
For women with a previous diagnosis of breast cancer or ovarian cancer and/or a family history of breast or ovarian cancer, the National Comprehensive Cancer Network provides recommendations for when genetic counseling and testing may be needed. These recommendations are based on your familys history of cancer and how closely related you are to the person who developed cancer. Here are some important definitions to know:
“First-degree relatives” include parents, siblings, and children.
“Second-degree relatives” include aunts/uncles, grandparents, grandchildren, and nieces/nephews.
“Third-degree relatives” include first cousins, great-grandparents, or great-grandchildren.
Genetic testing should be considered if a person or family meets 1 or more of the criteria listed below:
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