Why Do Genetic Testing For Cancer
The biggest reason for me to do genetic testing is that some of the genetic mutations increase your risk for other types of cancer. If I test positive, I may need to take steps to reduce my risk of getting these other cancers. One of these is ovarian cancer. Unlike breast cancer, we dont have good screening tests to find ovarian cancer early. If I’m at higher risk, doctors might recommend I get my ovaries and fallopian tubes removed around age 40.
At the time of this appointment, Im 37. I think about the two major surgeries Ive already had and how much I dont want to go through another one.
This is a lot of information to take in, Thomas says. How are you feeling?
I pause for a deep breath and admit I feel overwhelmed. But Im really grateful for the information. Id rather know, so I can do everything I need to do to prevent cancer.
Thomas reminds me this isnt an emergency. I dont have cancer yet. The profiler says I only have a 3% chance of getting it in the next decade. So we have time to get the information, think about it, and make a plan.
Thomas doesnt push me either way on testing. I decide I want to do it, but its totally up to me.
Having an appointment with me does not mean you have to go forward with testing, she says. Some people want to just come and hear the information. People sometimes feel like they need to be prepared for testing when all they actually need to be prepared for is to have a conversation.
When You Can’t Find Your Family History
While many women already know if their mother, sister, or daughter have had breast cancer, you might not have this information.
If your close family members passed away at a young age, if some of them didn’t have access to health care , if you were adopted, or if members of your family have been otherwise separated, you might not know which illnesses run in your family.
While family history is important information, breast cancer screenings are the most important tools for early detection, whether or not you have a family history of the disease.
What Are The Breast Cancer Chances
Factors that are associated with an increased risk of breast cancer include: Being female. Women are much more likely than men are to develop breast cancer. Increasing age. A personal history of breast conditions. A personal history of breast cancer. A family history of breast cancer. Inherited genes that increase cancer risk. Radiation exposure. Obesity. Beginning your period at a younger age. Beginning menopause at an older age.
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Cancers Linked To Radiation Treatment
Lung cancer: The risk of lung cancer is higher in women who had radiation therapy after a mastectomy as part of their treatment. The risk is even higher in women who smoke. The risk does not seem to be increased in women who have radiation therapy to the breast after a lumpectomy.
Sarcoma: Radiation therapy to the breast also increases the risk of sarcomas of blood vessels , bone , and other connective tissues in areas that were treated. Overall, this risk is low.
Certain blood cancers: Breast radiation is linked to a higher risk of leukemia and myelodysplastic syndrome . Overall, though, this risk is low.
Breast Cancer And Your Risk
For readers interested in the PDF version, the document is available for downloading or viewing:
This brochure identifies biological as well as lifestyle factors associated with breast cancer. It offers information and advice to help you better understand and address them. It also identifies common misconceptions about breast cancer and includes helpful tips and useful website addresses to help you stay informed.
It is intended for women who:
- are 18 years of age or over and
- do not have breast cancer or any breast problems. You should report any changes in your breasts or concern you might have about your breasts to your doctor.
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Do I Need Cancer Screenings More Often Than Other People
You are probably having screenings to check for a recurrence of the first cancer. Your doctor can also tell you if you need to be screened for other cancers. You should get these on the schedule your doctor recommends. If you have a high risk of cancer, you might have screenings more often than other people. Tell your doctor as much as possible about your family history and past cancer treatment.
Relative Risks Less Than 1
A relative risk less than 1 means the risk factor lowers the risk of disease.
For example, women who breastfeed for a year have a relative risk of breast cancer of about 0.94 compared to women who dont breastfeed.
You may see:
- Women who breastfeed have a 6 percent lower risk of breast cancer compared to women who dont breastfeed.
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What Are The Odds Of Getting Breast Cancer Twice
Dr. Barry Rosenbreast cancerbreast cancerDr. Kathryn WagnerDr. Regina Hamptonbreast canceroncologist geneticcancer
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What Causes Breast Cancer In Your 20s And 30s
Breast cancer happens when cells in the breast begin to grow and multiply abnormally. Changes in DNA can cause normal breast cells to become abnormal.
The exact reason why normal cells turn into cancer is unclear, but researchers know that hormones, environmental factors, and genetics each play a role.
Roughly 5 to 10 percent of breast cancers are linked to inherited gene mutations. The most well-known are breast cancer gene 1 and breast cancer gene 2 . If you have a family history of breast or ovarian cancer, your doctor may suggest testing your blood for these specific mutations.
Breast cancer in your 20s and 30s has been found to differ biologically in some cases from the cancers found in older women. For example, younger women are more likely to be diagnosed with triple negative and HER2-positive breast cancers than older women.
Here are some statistics about breast cancer in women under 40:
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Previous Breast Cancer Or Lump
If you have previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast.
A benign breast lump does not mean you have breast cancer, but certain types of breast lumps may slightly increase your risk of developing cancer.
Some benign changes in your breast tissue, such as cells growing abnormally in ducts , or abnormal cells inside your breast lobes , can make getting breast cancer more likely.
Can I Lower My Risk Of Getting A Second Cancer
There’s no sure way to prevent all cancers, but there are steps you can take to lower your risk and stay as healthy as possible. Getting the recommended early detection tests, as mentioned above, is one way to do this.
Its also important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen after breast cancer.
To help maintain good health, breast cancer survivors should also:
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Risk Factors You Can Change
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
- Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
- Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.
What Happens If You Find Out Youre At Higher Risk
If you and your doctor determine that youre at a higher risk of breast cancer, you can decide together on next steps. Routine breast cancer screening is important for all women, but even more so for those at higher risk, so your doctor may suggest you get screened earlier and more often than other women.
You can also talk to your doctor about options for reducing your risk. Depending on your unique situation, your doctor may recommend either of the following:
- Risk-lowering drugs. Tamoxifen and raloxifene are the only drugs FDA-approved for breast cancer risk reduction in women at higher risk. Both are taken in pill form.
- Preventive surgery. For people with certain gene mutations, having surgery to remove their breasts may dramatically reduce their risk of breast cancer. Surgical removal of the ovaries can also reduce the risk of ovarian and possibly breast cancer for certain people.
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Radiation To Chest Or Face Before Age 30
If you had radiation to the chest to treat another cancer , such as Hodgkin’s disease or non-Hodgkin’s lymphoma, you may have an increased risk of breast cancer. If you had radiation to the face as an adolescent to treat acne, you may have an increased risk of developing breast cancer. A breast cancer risk expert can help you determine whether your risk is increased and what options you might have to reduce your risk.
Clinical Considerations And Recommendations
How should individual breast cancer risk be assessed?
Health care providers periodically should assess breast cancer risk by reviewing the patients history. Breast cancer risk assessment is based on a combination of the various factors that can affect risk Box 1610111213. Initial assessment should elicit information about reproductive risk factors, results of prior biopsies, ionizing radiation exposure, and family history of cancer. Health care providers should identify cases of breast, ovarian, colon, prostate, pancreatic, and other types of germline mutation-associated cancer in first-degree, second-degree, and possibly third-degree relatives as well as the age of diagnosis. Women with a potentially increased risk of breast cancer based on initial history should have further risk assessment. Assessments can be conducted with one of the validated assessment tools available online, such as the Gail, BRCAPRO, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, International Breast Cancer Intervention Studies , or the Claus model 34.
Is screening breast self-examination recommended in women at average risk of breast cancer, and what should women do if they notice a change in one of their breasts?
Should practitioners perform routine screening clinical breast examinations in average-risk women?
When should screening mammography begin in average-risk women?
How frequently should screening mammography be performed in average-risk women?
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Does Insurance Cover Genetic Counseling And Cancer Screenings
My private insurance covered the cost of my genetic counseling appointment and testing. This is true of most private insurances, but not Medicare. My insurance helps cover the cost of recommended breast cancer screenings.
UVA Health offers price estimates for these and other services. Some patients qualify for financial assistance based on their income.
What Causes Breast Cancer
Many different things can affect your chances of getting breast cancer.
Theres no single cause. It results from a combination of the way we live our lives, our genes and our environment.
We cant predict who will get breast cancer. And we cant confidently say what might have caused someones breast cancer.
There are, however, some things you can do to lower your chances of getting it.
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Family History And Inherited Genes
Some people have a higher risk of developing breast cancer than the general population because other members of their family have had particular cancers. This is called a family history of cancer.
Having a mother, sister or daughter diagnosed with breast cancer increases the risk of breast cancer. This risk is higher when more close relatives have breast cancer, or if a relative developed breast cancer under the age of 50. But most women who have a close relative with breast cancer will never develop it.
Some people have an increased risk of breast cancer because they have an inherited gene fault. We know about several gene faults that can increase breast cancer risk and there are tests for some of them. Having one of these faulty genes means that you are more likely to get breast cancer than someone who doesnt. But it is not a certainty.
Two of these faulty genes are known as BRCA1 and BRCA2. These are not common. Only about 2 out of every hundred of breast cancers are related to a change in the BRCA1 or BRCA2 genes.
Ionising radiation includes tests such as x-rays and CT scans and treatment such as radiotherapy.
Who Is Most At Risk Of Developing Breast Cancer
1. The strongest risk factor for breast cancer is age. Therefore, older women are at a higher risk of developing breast cancer than younger women.
2. Another significant risk factor is carrying a gene that predisposes to the development of breast cancer, such as the BRCA 1 and 2 genes. Related to carrying a gene that causes breast cancer, having a strong family history of breast cancer also increases a persons risk. Women who carry a gene that causes breast cancer or women who have a strong family history of breast cancer are at higher risk than women who do not.
3. Another risk factor for breast cancer is having a history of a breast biopsy that showed atypical cells, such as atypical ductal hyperplasia or lobular carcinoma in situ.
4. Lastly, there are several risk factors associated with a woman’s exposure to hormones throughout her lifetime, such as early menarche, number of pregnancies, whether or not a woman has breastfed, late menopause, that impact breast cancer risk. The more a woman has been exposed to estrogen and the more menstrual cycles she has experienced, the higher her risk of developing breast cancer.
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What Can I Do
Be proactive. Increasing your awareness and knowledge may help reduce your risk of developing breast cancer. Take action on your lifestyle risk factors. Know your body, watch for changes, and contact your health care provider with any questions or concerns about breast health and breast cancer prevention, early detection and screening.
Understanding Your Risk Of Breast Cancer
Several breast cancer risk assessment tools have been developed to help a woman estimate her chance of developing breast cancer. The best studied is the Gail model, which is available on the National Cancer Institutes website at www.cancer.gov/bcrisktool. After you enter some personal and family information, including race/ethnicity, the tool provides you with a 5-year and lifetime estimate of the risk of developing invasive breast cancer. Because it only asks for information about breast cancer in first-degree family members and does not include their ages at diagnosis, the tool works best at estimating risk in women without a strong inherited breast cancer risk. For some women, other ways of determining the risk of breast cancer may work better. For example, women with a strong family history of breast cancer risk should consider talking to a genetic counselor.
It is important to talk with your doctor about how to estimate your personal risk of breast cancer and to discuss risk-reducing or prevention options .
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Benefits Of Mammographic Screening
The ACS systematic review also examined the effect of screening mammography on life expectancy. Although the review concluded that there was high-quality evidence that mammographic screening increases life expectancy by decreasing breast cancer mortality, the authors were not able to estimate the size of the increase 23.
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Here are ten common myths about breast cancer:
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