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What is hereditary breast cancer?

Less than 10 percent of all cancers, including breast cancers, are actually caused by an inherited genetic mutation, according to estimates.
October is National Breast Cancer Awareness Month. Roughly one in every 8 women in the United States will receive a breast cancer diagnosis sometime during their lifetimes, according to estimates.

It’s estimated that one in every eight women in the United States will receive a breast cancer diagnosis sometime during their lifetimes. So it’s understandable why many women come to the University of Minnesota Health Cancer Care Cancer Risk Management Program to ask about their risk for hereditary breast cancer.

It’s been wonderful to meet so many proactive women who are taking charge of their health by asking important questions. Many women have expressed concern about breast cancer in their families and want to know whether these risks are hereditary. A “hereditary” cancer means that the cancer is caused by a change, or a “mutation” in a single gene that is passed down in families.

Although women may have “familial cancers,” meaning that multiple family members have had breast cancer, it is estimated that only 5-10 percent of all cancers, including breast cancers, are actually caused by an inherited genetic mutation. Most cancers are considered to be “sporadic,” or caused largely by environmental factors (smoking, sun or chemical exposure, aging, among other factors).

October is National Breast Cancer Awareness Month. To mark the occasion, here are a few tips to consider if you’re wondering whether you should be tested for hereditary breast cancer.

  • Prior to having genetic testing, see a genetic counselor. They are the best informed specialists, with graduate level degrees in genetic counseling. They are most familiar with all methods used to assess family history, and will know the right type of test for you. They can help determine which set of targeted genetic tests you should use, which can make genetic testing more affordable.

  • You should consider genetic testing if you have:
    • Multiple people (men or women) in your family who were diagnosed with breast cancer prior to age 50
    • Cancers in multiple closely related relatives (siblings, parents, etc.)
    • Family members with related cancers (such as breast/ovarian or breast/uterine/thyroid). There are several “constellations” of cancers that constitute a syndrome and genetic counselors will look at your family for these.
    • The same type of cancer in multiple generations.
Learn more about our Cancer Risk Management program

Hereditary Breast and Ovarian Cancer Syndrome is typically caused by genetic mutations in BRCA1 and BRCA2 genes; it is estimated that these mutations occur in one out of every 300-500 people. It is estimated that the lifetime risk for breast cancer is approximately 64 percent in women with BRCA1 mutations and approximately 56 percent in those with BRCA2 mutation. Such inherited mutations can be passed down from either the mother’s or father’s side of the family. At least 16 other lesser-known genes may contribute to inherited breast cancer also, so seeing a genetic counselor prior to making the decision to be tested can help ensure that you are tested for the most likely problematic genes.

It’s important to note that having a genetic mutation does not mean a certain person will get cancer. It simply means a person at higher risk for that cancer than the general population. Knowing the level of risk is important because it can help you decide how to manage the risk. Some opt for frequent screenings and surveillance. Other, particularly high risk patients (those with BRCA1 and BRCA2, for example), may undergo preventative surgery to remove their breasts or ovaries.

Our program is designed to help patients who deemed “high-risk” develop a plan to help find any cancer at its earliest stages. My nursing career has taught me that early detection is key to successful treatment.

Who in my family should see a genetic counselor or receive genetic testing first?

  • If you have concerns about your risk for hereditary breast cancer, and you have a close relative in your family – especially a young person, under the age of 50 – with breast cancer, the best way to gather information about hereditary cancer is to have that person have genetic counseling. You can decide upon any follow-up action once you have the results of his or her tests.
  • If you discover that you are at higher risk for hereditary breast cancer, you may need a higher level of screening and surveillance than most women. Screening with mammography and/or breast MRIs may start at a younger age, depending on what is known about a woman’s personal risk. Screening for other types of cancer, such as ovarian cancer, may be warranted too.
  • Knowing your risk can empower you to be proactive in doing everything you can to safeguard your health and prevent or detect cancer early.