Who should get genetic for breast cancer genes?
Ms. G. is a 40-year-old woman with two small
children. Like most women, she is concerned about her chances of developing
breast cancer. She asks her doctor about her risks.
Although breast cancer is a worry for most women, Ms. G. is especially worried because of a
family history of breast cancer. Her mother and sister had breast cancers that were diagnosed
at young ages.
A woman with a family history of breast cancer
has a lot of concerns. Among other things, she is thinking of her job, children,
and husband, as well as how her medical insurance and health team will be able
to serve her needs in the future should she be diagnosed with breast cancer.
What are the facts about families that have multiple members with breast cancer?
Overall, inherited breast cancer disorders account for a small minority of breast cancers. Genes are the “messages” in each cell of the body that determine the ultimate design of our bodies. Genes can be damaged by the environment. Additionally, people can be born with defects in the genes that remove the body’s defenses against cancers. Only in about 10% of all breast cancer cases is there actually an inherited genetic defect that can be
detected by testing. In fact, most cases of breast cancer occur in women who do not have a family history of breast cancer. A complex interplay between environmental and genetic factors affects the development of breast cancer, and all the key factors have not yet been identified.
How do you decide whether she should get genetic testing?
The whole issue of genetic testing for breast
cancer is complicated. Recent research indicates that the information women seek
most often when they request genetic testing does not match what they can
realistically determine from this testing. Nevertheless, it is worthwhile to
consider the role of this testing and what it involves.
Certain characteristics make a woman at higher
risk for genetic breast cancer disorders. These factors include:
- family members with breast cancer, especially at a young age;
- breast cancer
in a male family member;
- both breast and ovarian cancer in the family;
- bilateral breast cancer in a single family member;
cancer diagnosed at very young ages; and
- being of Ashkenazi Jewish descent.
Ms. G. and her doctor determine that she falls within the group with higher risk factors
because her sister and mother both had breast cancer at young ages.