Section 2: Breast Cancer Risk and Your Family

HIGHLIGHTS

  • The goal of this section is to help you understand how genes you inherit from a parent may increase your risk of breast cancer, and to take action to reduce risks for yourself and members of your family.

  • Breast cancer can run in families due to shared lifestyles and genetics.

  • About 5% to 10% of women with breast cancer have a mutation in the BRCA 1 or 2 genes that increased their cancer risk. These genes are passed down in families from mother or father to children.

  • Inherited breast cancers usually start at an earlier age. Some women get separate cancers in each breast at different times. Cancer in the ovaries is also more common in women with these gene mutations.

  • Young African American breast cancer survivors have higher risks of having a mutation in the BRCA genes than most other women with breast cancer—yet they are less likely to see a genetic counselor or get genetic testing.

  • Women with triple-negative cancers are more likely to have a mutated BRCA1 gene compared to women who do not have triple negative cancers.

  • Ask your oncologist or primary care doctor about genetic counseling. A genetic counselor can help you discover more about your family history and help you decide whether to have genetic testing.

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SUMMARY

WHY DOES BREAST CANCER RUN IN FAMILIES?

If a woman has one first-degree relative (mother, sister, or daughter) with breast cancer, her own risk of getting breast cancer doubles compared to women without a family history. Having 2 first-degree relatives triples her risk. Breast cancer can run in families due to shared lifestyles and genetics.

FINDING OUT IF YOUR FAMILY HAS A GENETIC BREAST CANCER RISK

Some “pink flags” in a family’s health history warn that a mutated gene may be increasing breast cancer risk. BRCA1 or BRCA2 mutations are found in about one in four families that have several of the “pink flags” below. Remember that warning signs may be found either in your father’s or your mother’s side of the family.

  • You have 3 relatives (mother, sister, daughter, aunt, grandmother, or first cousins) with breast cancer no matter what age they were diagnosed.

  • You have a relative (mother, sister, daughter, aunt, grandmother, or first cousin) with breast cancer and a relative who has had ovarian or fallopian tube cancer. (BRCA1 or BRCA2 mutations also greatly increase the risk of these cancers).

  • Someone in the family (including yourself) was diagnosed with triple-negative or basal-like breast cancer before age 60.

  • A man in the family had breast cancer.

SHOULD YOU GET GENETIC COUNSELING?

A genetic counselor has special training to help people understand the medical facts about genetic risks and make informed choices to protect their health. After talking with a genetic counselor, you can decide whether to have a blood test to see if you carry a gene mutation that would increase your risk of breast and other cancers. If you get tested you will have at least one other visit to talk about the findings. The counselor can help you understand your test results and make choices about your future health care.

PROTECTING YOUR HEALTH IF YOU ARE AT HIGH RISK FOR CANCER

If you do have a BRCA1 or BRCA2 mutation known to increase cancer risk, your choices would include the following:

  • Changing your lifestyle to avoid risk factors that increase cancer risk

  • Getting special tests for breast and ovarian cancers at regular intervals

  • Having surgery to remove areas of the body at very high risk for cancer (before cancer is found)

  • Taking hormones and other medications known to lessen the risk of cancer in women with a mutated gene

  • Letting other family members know that they could also have a high risk for cancer and have the option to be tested for a mutation

COPING WITH WORRIES ABOUT INHERITED BREAST CANCER

No matter what choices you make about having genetic counseling, testing, or treatments to prevent cancer, recognizing a pattern of cancer in your family can be upsetting. If you decide on testing and find out that you are a carrier, you probably will continue to be worried about your future health, but knowledge is power. Even if you discover you have a gene mutation, there is more to your story. The exact kind of error in a gene can help to predict your future risk of cancer. Of course women who are not carriers still have the average 1 in 9 lifetime risk of breast cancer and should continue to get routine mammograms. However, studies show that people who find out they are not at extremely high risk of cancer usually feel much less fearful.

WHAT TO DO IF YOU DO NOT HAVE A BRCA1 OR BRCA 2 MUTATION?

If you do not carry a mutated gene, you still have the same risk of getting breast cancer as the average young African American woman—higher than women your age of other races. You should still get recommended screening tests and choose healthy habits like staying at a healthy weight, exercising regularly, not using tobacco, and not drinking heavy amounts of alcohol. If you are already a breast cancer survivor, you should follow your oncologist’s advice for screening for future cancer or for other health risks linked to your cancer treatment.


Click here for more in-depth information on Talking with Family and Deciding on Genetic Counseling.


Section 2: Breast Cancer Risk and Your Family

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African American YBCS Survivor Quote

“I was diagnosed the end of April (2009) with Stage 3 breast cancer in the left breast. I had surgery on May 7, 2009. I had to end up having a mastectomy, and I am now going through chemo treatments. So far I have had four treatments, and I have twelve more to go, and radiation as well. I have good days as well as bad. I’m so grateful to be alive. I have a sister who is Stage 3 as well right now, walking through what I am. My mom had breast cancer last year. I know that there is a reason. All I can do is trust God.”