Breast Cancer and Genetic Testing :: A Genetic Counselor Weighs In

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Note: I am a genetic counselor, but I'm not YOUR genetic counselor. This information is hopefully helpful, but each person's situation is different. Want to meet with a genetic counselor? Find one near you at: findageneticcounselor.com

There’s a lot you can inherit from your family: your hair color, your eye color, your morbid sense of humor…but what about a higher risk for breast cancer?

Small hands with medium-dark skin behind a pink background. The hands are holding a pink breast cancer awareness ribbon.
Some families are at a higher risk for breast cancer. Is yours?

Unfortunately, breast cancer is pretty common: about 1 in 8 women will develop it over their lifetime. But for some women, because of their genetics, the risk is a lot higher.

About 5-10% of the time, breast cancer is due to a genetic condition (called a cancer predisposition syndrome). This means that a person’s risk to develop cancer is much higher compared to other people. Are you worried that your family has a breast cancer predisposition syndrome? Here are some things to consider.

How do I know if hereditary breast cancer runs in my family?

Here are some “red flags” that may pop up in a family that carries a higher risk for breast cancer:

1.) Breast cancer diagnosed before the age of 50 years

2.) Bilateral breast cancer (cancer has been found in both breasts)

3.) Multiple generations affected with breast cancer (for example: if a grandmother, mother, and daughter are all diagnosed with breast cancer)

4.) Male breast cancer

5.) Certain ancestral backgrounds, such as Ashkenazi Jewish ancestry

I’m worried that my family has a higher risk for breast cancer. What should I do next?

Meeting with a genetic counselor can be really useful. A genetic counselor will ask detailed questions about your personal and family history and use that information to assess how likely it is that a genetic change (called a mutation) is passing through the family. They may also talk to you (or your family members) about doing genetic testing, which involves testing the DNA that you were born with to see if you have a mutation. Sometimes talking about all this is really scary! The genetic counselor is also trained to address any thoughts, feelings, or concerns you have along the way.

What happens if I test positive for a mutation?

Your health care providers will make recommendations about breast screening based on your personal and family history, and your genetic test result. Usually, this means beginning breast screening (mammograms and ultrasounds) at earlier ages, or doing them more frequently. It may also involve more detailed screening like a breast MRI. Some women choose to have their breast tissue removed, even if they don’t have cancer, to reduce the risk as much as they can (this is called a prophylactic mastectomy).

I have a lot more questions about hereditary cancer! Where can I go to learn more?

To find a genetic counselor near you, go to findageneticcounselor.com.

Here are some great resources for more information about hereditary breast cancer:

1.) Facing Our Risk of Cancer Empowered (FORCE)

2.) Cancer.org Genetic Counseling and Testing for Breast Cancer Risk

3.) Bring Your Brave campaign from the CDC

Breast cancer is scary, but there are things you can do to better understand and manage your risk. There’s lots of support out there to help address your questions and fears, and health care providers (like genetic counselors) to help you navigate it all!

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Gina spent most of her formative years in Collierville, left for college and graduate school, returned to Memphis in 2012, and has been here ever since. She is a genetic counselor at St. Jude Children’s Research Hospital, where she assists families in better understanding genetic contributions to childhood cancer. She and her husband live in Midtown Memphis and have a daughter (April 2018) and a son (January 2020). In her spare time, Gina enjoys listening to too many podcasts, reading, trying new skin care products, and finding her next Netflix binge.

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