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. Unfortunately the Gail Model does not take into account paternal (father’s side), 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 different type of 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, even without a family history of breast cancer. A DNA sample is taken from a cheek / saliva 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 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. Insurance does not currently cover the test, but the company has various promotional offers to help keep the cost manageable. Other companies are now starting to offer a risk score, so it is expected that over time, costs will decrease.
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. Through a blood or 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, such as PALB2, ATM, ChEK2 and others, 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.
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.