With Angelina Jolie's recent disclosure of her BRCA mutation carrier status and decision to have a preventative mastectomy, many women may be wondering about breast cancer risk and genetic testing.
One in 8 women will develop breast cancer in their lifetime. Risk factors include age, ethnicity, lifestyle, family history and genetic conditions. Genetic counselors can evaluate a family history to determine if there may be an increased risk for breast cancer, or a risk for a hereditary form of breast cancer.
Five to 10 percent of breast cancers are hereditary, which means they are due to a specific gene that is passed down in a family. The most common cause of hereditary breast cancer is an inherited change, known as a mutation, in the BRCA1 or BRCA2 genes.
Normally, these genes work to prevent breast and ovarian cancer. However, if a woman has inherited a changed copy of either gene, she has a high risk of developing breast cancer and ovarian cancer — as high as 87 percent for breast cancer and as high as 44 percent for ovarian cancer.
Genetic testing can identify families with hereditary breast cancer due to BRCA mutations. By identifying individuals who carry these genetic changes, genetic counselors are able to discuss increased screening and preventative surgery options with other family members who have inherited the same genetic risk factor. Most insurance companies cover BRCA testing if an individual meets certain family history or personal history criteria.
Although the majority of breast cancers are not hereditary, family history alone can impact the risk for breast cancer. Having a sister, mother or daughter who has been diagnosed increases the risk. Breast cancer on your father's side of the family can also impact your risk.
If there is a family history of breast cancer, the general recommendation is for other women to start screening 10 years earlier than the youngest woman's diagnosis. For example, if a woman has been diagnosed at age 45, other women in the family should start mammograms at age 35. Additionally, if you are found to be at an increased risk for breast cancer based on family history, a breast MRI may be recommended as well as an annual mammogram.
The majority of women who are diagnosed with breast cancer will have no family history of the disease. This is why annual mammograms starting at age 40 are so critical. Discuss breast cancer screening with your physician to determine what would be most appropriate for you.