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 are still developing. Radiation treatment in older women does not seem to increase breast cancer risk.
What Should I Do If I Am Concerned
If you are concerned about a history of breast cancer in your family you should see your GP. They will want to take a family history. Before seeing your GP, it is a good idea to try to find out who in your family has been diagnosed with breast cancer , at what age they were diagnosed and their exact blood relationship to you.
Your GP will wish to know any relevant details about first- and second-degree relatives .
- First-degree relatives are mother, father, daughters, sons, sisters, or brothers.
- Second-degree relatives are grandparents, grandchildren, aunts, uncles, nieces, nephews, half-sisters and half-brothers.
On the basis of the family history, it is usually possible for your GP to assess your risk as either near-normal, moderate, or high. If your risk is moderate or high then, if you wish, you may be referred to a doctor who is a specialist for further assessment and counselling.
For details of the factors used to assess the risk, see the website of the National Institute for Health and Care Excellence under ‘Further reading & references’, below. It has produced guidelines which doctors can refer to when assessing the risk of breast cancer for individual women.
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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Genetic Counseling Is A Must For Men
All men with breast cancer should be referred for genetic counseling, Prowell advises.
Thats another difference from women, who are not automatically referred to a genetic counselor for genetic testing, such as for mutations in BRCA-1 or 2. Even among men there are differences. African American men are more likely than white men to have advanced stage tumors at diagnosis and to develop triple-negative cancers. Their types of tumors are more likely to recur and have fewer treatment options.
People should tell their health care provider if any man in their family has had breast cancer, Prowell says. Even if your grandfather is deceased, if he had breast cancer, thats important. Because male breast cancer is so rare, seeing even one man in a family lineage raises concerns about hereditary breast cancer, Prowell adds.
Symptoms Of Breast Cancer In Men
Each year, about 2,000 cases of male breast cancer are diagnosed in the United States, resulting in about 500 deaths, according to the National Cancer Institute. Although it can strike at any age, breast cancer is usually diagnosed in men ages 60 to 70.
Why does it often take so long to recognize the signs of breast cancer in men? One reason for the late-age diagnosis may be that men, and their doctors, dont think they are at risk of breast cancer.
Youd think that because men have smaller breasts, they would get diagnosed at an earlier stage than women, Prowell says. In many men, though, diagnosis is actually delayed because men and their doctors arent expecting a breast lump to be cancer.
Most men with breast cancer have painless lumps they can feel. The lumps can develop anywhere on the breast and often are underneath the nipple and areola complex right in the center. Because men dont have regular mammograms, their breast cancer may be discovered after a local injury, such as a fall or minor chest wall trauma, leads them to feel the breast area.
Men commonly attribute a breast lump to some sort of injury. The mass was already there, but they didnt notice it until it got sore after they were bumped in the chest, for example, Prowell explains.
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All Cancers Are Caused By Genetic Mutations But Not All Genetic Mutations Are Inherited
When the genes that suppress tumors dont function correctly, cells divide uncontrollably, form cancerous tumors, and, if not treated, spread throughout the body. Thats what we call cancer. Often, these genes turn faulty because of some environmental factor . Other times, you inherit a copy from your parents or grandparents. Thats an inherited mutation.
Act Like A Detective About Your Family History Of Cancer
Relatives dont like to share medical information and the older they are, the less likely they are to talk. Or as Ross puts it, Having cancer conversations with family brings out the crazies in all of us. Just knowing that helps you tolerate the crazies. Start by writing down medical information about every close family member, beginning with yourself. Then, at family gatherings, collect information in a casual way, by asking relatives for stories about their life rather than grilling them. Then go home and record the information .
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How Does Breast Cancer Start
Breast cancer starts when cells in the breast begin to divide and grow in an abnormal way.
All cells contain genes that tell them how to grow and function. Sometimes a change can occur in a gene that means the cells begin to function in an abnormal way. This is known as an altered gene .
Altered genes can be either inherited or acquired.
- Inherited altered genes are passed down from one of our parents.
- Acquired altered genes develop due to a combination of things such as getting older and environmental and lifestyle factors.
Although breast cancer is very common, only a small percentage of cases are due to inheriting an altered gene.
For more information on genes and cancer see the Cancer Research UK website.
There Are Certain Clues That Tell You Whether Cancer Is Hereditary
If your dad was a heavy smoker who died of lung cancer, its a good bet that the cancer he died from was environmentally caused rather than caused by a large inherited component, says Ross. But watch for these signs: Several close family members were diagnosed with cancer before age 50 multiple family members have the same type of cancer there are many cases of a rare cancer in the family relatives have gotten cancer in both pairs of organs .
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Genetic Testing For Hereditary Breast And Ovarian Cancer
Genetic testing is available for hereditary breast and ovarian cancer. Most breast and ovarian cancer is not caused by inherited mutations, so genetic testing will not help most women with a family health history of breast and ovarian cancer. Genetic testing will not identify the cause for some hereditary breast and ovarian cancers, because the genes affected in these cancers are not yet known.
Genetic counseling before genetic testing for hereditary breast and ovarian cancer is important to determine whether you and your family are likely enough to have a mutation that it is worth getting tested. Usually, genetic testing is recommended if you have:
- A strong family health history of breast and ovarian cancer
- A moderate family health history of breast and ovarian cancer and are of Ashkenazi Jewish or Eastern European ancestry
- A personal history of breast cancer and meet certain criteria
- A personal history of ovarian, fallopian tube, or primary peritoneal cancer
- A known BRCA1, BRCA2, or other inherited mutation in your family
The BRCA1 and BRCA2 genes
Genetic counseling after genetic testing is important to help you understand your test results and decide the next steps for you and your family:
How Current Guidelines Hinder Genetic Testing
The guidelines of genetic testing are very complex and differ based on the type of cancer diagnosed, Niloy Jewel J. Samadder, MD, director of the high-risk cancer clinic at the Mayo Clinic in Arizona, tells Verywell. These criteria have been shown in our study and others to not be sensitive for ruling out the presence of a genetic cause of cancer.
According to Samadder, guidelines have already been implemented to support genetic testing for patients with ovarian or pancreatic cancer. However, the same level of adoption has not been applied to other types of cancers, including breast cancer.
Based on the results of the INTERCEPT study the goal should be to offer genetic testing to any patient with a personal history of cancer,” Samadder says. “Mayo Clinic is taking the steps to make this a reality in 2021.”
The clinic is working through steps to ensure that any patient who receives care at a Mayo Clinic Cancer Center will receive a comprehensive genomic evaluation designed to:
- Identify the cause of their cancer
- Determine the risk of cancer in their families
- Find precision-targeted therapies to improve their chance of survival
Despite the Mayo Clinic’s groundbreaking move, it remains uncertain whether other healthcare organizations will follow suit.
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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.
Breast Cancer: Risk Factors And Prevention
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will find out more about the factors that increase the chance of developing breast cancer. Use the menu to see other pages.
A risk factor is anything that increases a persons chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.
Most breast cancers are sporadic, meaning they develop from damage to a persons genes that occurs by chance after they are born. There is no risk of the person passing this gene on to their children, as the underlying cause of sporadic breast cancer is environmental factors.
Inherited breast cancers are less common, making up 5% to 10% of cancers. Inherited breast cancer occurs when gene changes called mutations are passed down within a family from parent to child. Many of those mutations are in tumor suppressor genes, such as BRCA1, BRCA2, and PALB2. These genes normally keep cells from growing out of control and turning into cancer. But when these cells have a mutation, it can cause them to grow out of control.
The following factors may raise a womans risk of developing breast cancer:
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How Do Certain Genes Affect Breast Cancer
Cancer is a health condition that can be caused by changes to your genes. Your genes carry instructions that tell the proteins in your cells how to behave.
When your genes cause proteins and cells to develop in abnormal ways, it can become cancer. This can happen because of a gene mutation.
Its possible to be born with certain gene mutations. This is called an inherited mutation. Somewhere between 5 to 10 percent of breast cancers are currently thought to be hereditary. Your genes may also mutate later in life due to environmental or other factors.
A few specific mutations can play a role in developing breast cancer. Affected genes tend to be ones that control things like cell growth and the DNA in your reproductive organs and breast tissue.
BRCA1 and BRCA2 genes typically make proteins that can repair your DNA when it gets damaged, particularly in your breasts and ovaries. When these genes are mutated, it can cause abnormal cell growth. These cells can then become cancerous.
People born with a penis and who have the BRCA2 mutation have an increased risk of developing male breast cancer.
Your risk for having BRCA1 or BRCA2 mutations may be higher if you have:
In addition to BRCA and BRCA2, there are other genes that can increase your risk of developing breast cancer if you inherit a mutation.
These genes include:
How Is Breast Cancer Inherited
Genes are short segments of DNA found in chromosomes. DNA contains the instructions forbuilding proteins. Proteins control the structure and function of all the cellsthat make up your body.
There are two types of DNA changes: those thatare inherited and those that happen over time. Inherited DNA changes are passeddown from parent to child. Inherited DNA changes are called germ-linealterations or mutations.
DNA changes that happen over the course of alifetime, as a result of natural aging or exposure to chemicals in theenvironment, are called somatic mutations.
Some DNA changes are harmless, but others cancause disease or other health issues. These DNA changes that negatively affecthealth care called mutations.
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What To Do If Youre Worried
Speak to a GP if cancer runs in your family and youre 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. Its 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.
Considerations For Genetic Testing
If you meet any of the criteria that increases your risk of having BRCA1 or BRCA2 mutations, as listed above, you may be considering genetic testing.
Genetic testing for BRCA1 or BRCA1 is usually a simple blood or saliva test. After a conversation and a prescription from a doctor, youll have a sample of your blood or saliva drawn and sent to a lab. The lab looks for the mutations, and the doctor will call you with the results.
You can also pay a direct-to-consumer company to do the test without a referral from your doctor. But these tests only test for BRCA1 and BRCA2 gene mutations. They cant rule out any and all factors that could increase your risk of breast cancer.
If youre curious about other genetic mutations that you may have, youll need to speak with a doctor about getting tested for those mutations, too.
The National Comprehensive Cancer Network offers criteria for who should consider getting a genetic test for BRCA1 and BRCA2 mutations, in addition to other gene mutations including those discussed above. Just know that insurance may not always cover genetic testing.
Currently, these tests arent seen as necessary or recommended for the general public. Genetic testing is only recommended if you have a family history of breast cancer or ovarian cancer.
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