While most women are aware that having a family history of breast cancer increases their risk of developing the disease, the fact remains that as many as 75% of women newly diagnosed with breast cancer do not have any specific risk factors, other than being a woman. Approximately one in eight women will develop breast cancer over her lifetime.
Many risk factors cannot be controlled, such as family history, age at menarche (first period), and age at first pregnancy. However many more risk factors can be controlled. Lifestyle factors such as regular exercise, maintaining an ideal body weight, a diet low in saturated fat, and moderation in alcohol intake (3-6 drinks per week for women) will help reduce the risk of developing breast cancer.
Evaluation of your risk using a risk-assessment model may help put your concerns in proper perspective. While a risk-assessment model is not a crystal ball, many women overestimate their risk. The most commonly used risk assessment model is the Gail Model, available from the National Cancer Institute Website. Unfortunately the Gail Model does not take into account paternal or any 2nd degree relatives or age at diagnosis but it is a good starting point. The Tyrer-Cusik and other risk assessment models do take into account both maternal and paternal relatives, as well as other factors.
BrevaGEN is a newer risk assessment tool. Unlike BRCA gene testing (see below) which is primarily for women with a strong family history of early breast cancer, the BrevaGEN test has been validated in African American, Caucasian, and Hispanic women, ages 35 and older. A genetic sample is taken using a cheek swab, and is tested for single nucleotide polymorphisms (SNPs) – variations in DNA known to be associated with elevated risk. The genetic result is combined with the Gail Model assessment to provide a 5 year and lifetime risk assessment. Unlike risk assessment computer models alone, the BrevaGEN result gives us important information about an individual patient’s risk of developing a breast cancer, and knowing that risk will allow us to develop a more tailored risk reduction and surveillance program. The majority of insurance carriers do cover the test, and we are proud to be one of the few facilities in our area to offer this test to our patients.
Depending on your specific family history, you may be a candidate for BRCA gene testing. A mutation in one of these genes will lead to a significantly increased risk of breast and/or ovarian cancer, as well as some other cancers. Using a saliva test, it can be determined if you are a carrier for one of these mutations, and this information can be very important in determining the appropriate imaging and treatment options. There are many other genetic mutations that have been identified which may result in an increased risk of breast and other cancers, and testing for these mutations may also be appropriate depending on your family history. F.O.R.C.E. is a national organization providing support and education for patients with genetic mutations that put them at high risk for breast and ovarian cancer.
The following video contains information about genetic counseling and testing:
When you are seen for a consultation, Dr. Attai will review your history and will discuss whether any of these testing methods is appropriate for you.
Dr. Attai does not provide online medical advice. The information provided is for general information only.
No online site should be used as a substitute for personal medical attention.