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Genetics and Family Risk Assessment FAQs

Updated June 3, 2010

I’m the only one in my family who has had breast cancer. Yet I’m worried about whether my preschool daughter will eventually be facing breast cancer at a young age, as I did. Should I get genetic testing?

Is it “better” to have the BRCA1 or BRCA2 gene mutation?

Q: I’m the only one in my family who has had breast cancer. Yet I’m worried about whether my preschool daughter will eventually be facing breast cancer at a young age, as I did. Should I get genetic testing?

A: Genetic testing isn’t just about the risk to your children. It also concerns your future cancer risks. Yet a 2005 survey of more than 1,200 young women with breast cancer found that less than half had discussed genetic testing with their doctors.

Although there may be no history of breast cancer in your family, by being a young woman affected by breast cancer, you may be at higher risk of having a gene mutation than an older woman. Because of that, some oncologists offer genetic testing to any woman under 40 (or even older) who’s been diagnosed with breast cancer.

If you carry one of the mutated BRCA genes, you also have an increased chance of developing a second breast cancer or ovarian cancer. That’s why many clinicians recommend, starting at age 25, that women with either BRCA mutation have alternating mammograms and breast MRIs, every six months.

BRCA1 and BRCA2 mutations may be inherited from either your mother or your father’s side of the family. Men with an abnormal BRCA gene have an increased risk of breast cancer, which can be passed to their daughters. Families with BRCA1 or BRCA2 mutations also show greater risk for cancers of the pancreas, larynx and prostate.

Meet with a genetic counselor first before deciding whether or not to have genetic testing, and get an understanding of the different tests that can be ordered and the possible results. Not all results are straightforward, and it is important to have someone on your healthcare team with formal training in genetics to ensure the proper interpretation is made and the appropriate test is ordered.

If you are tested and don’t have a genetic mutation in BRCA1 or BRCA2, but you have a strong family history, you may still have an inherited risk. Not all genetic risk for breast cancer is currently detectable. Your test results will help tailor risk reduction strategies. Talk with your genetic counselor or healthcare provider about what a negative test result may mean for you. For more information on breast cancer and genetics, visit our website community for women at high risk.

Q: Is it “better” to have the BRCA1 or BRCA2 gene mutation?

A: Having either mutation gives you a 60 to 80 percent greater risk of breast cancer, diagnosed at a younger age—on average, at 42. Women who do not have breast cancer but who carry the BRCA1 gene abnormality have a higher risk of eventually developing the disease than do women with BRCA2. In addition, both of these genetic mutations also increase the possibility of future ovarian cancer—with a higher risk among BRCA1 carriers.

For more information on breast cancer and genetics, visit our website community for women at high risk.

All FAQs reviewed by Jill Stopfer, MS

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