How Do You Know if You are Genetically Predisposed to Breast Cancer?
Newer, more available testing related to breast cancer is allowing both better prevention and treatment strategies.
Earlier this year, Hollywood superstar Angelina Jolie revealed she had had both breasts removed as a preventive measure after learning she was genetically predisposed to developing breast cancer. Both her mother and her aunt died from the disease and Jolie had genetic testing to determine her risk. In general, genetic testing is available to more people for a variety of cancers.
Several health care providers in Greeley offer the BRCA1/BRCA2 genetic testing and counseling in their offices. The Banner Women’s imaging department at North Colorado Medical Center at Summit View Medical Commons have recently begun a program to identify women at high risk at the time of their screening mammogram and offer the genetic testing and counseling services.
Banner Medical Group diagnostic radiologist Dan Kreider, MD, said many women with a high-risk for breast cancer are unaware of the Hereditary Breast and Ovarian Cancer Syndrome (HBOC) and its implications.
The women getting a screening mammogram at the SVMC complete a questionnaire that details their personal and family health history. The radiologists follow the guidelines of the National Comprehensive Cancer Network (NCCN) to identify patients that should be tested for those genes. Patients have a 45 percent chance of getting breast cancer in their lifetime for the BRCA 1 gene mutation and as high as 65 percent to 87 percent risk for the BRCA2 gene mutation. The risk for ovarian cancer for these patients is about 44 percent, Dr. Kreider said.
“It’s critical to get these patients identified,” he said. If there is a strong enough family or personal history of breast or ovarian cancer, the genetic testing is recommended and performed.
Dr. Kreider said obtaining the sample – a saliva test – is simple to perform, but the genetic evaluation of the sample can be expensive. Most insurance companies will cover the cost for patients that meet the NCCN high-risk categories.
“Once the BRCA gene is identified in a family, they know specifically which mutation to look for, and tests for the relatives of that first person are much less expensive.”
Dr. Kreider said it’s important to remind people that only 10 percent of breast cancer patients are related to the breast cancer gene. In fact, most breast cancer patients have no family history of breast cancer. “The number one risk factor for getting breast cancer is being a woman,” Dr. Kreider said. “But, for those patients with the breast cancer gene, the risk is very high. In addition, for those patients diagnosed with BRCA1 or 2, all of that patient’s siblings and children would have a 50 percent chance of having inherited the gene and need the genetic test, including the males. Testing the children of these patients can wait until around age 20.”
Dr. Kreider said many patients who learn they have the breast cancer gene opt to have both breasts removed.
One recent, high profile example of this is movie star Angelina Jolie, who opted for a double mastectomy after her mother and aunt both died of breast cancer. She has spoken out and written publicly about her decision, bringing much attention and public debate to the topic.
Some women also choose to have their ovaries surgically removed after they are done having children. The alternative to surgery is to have annual mammograms, annual breast MRIs, annual pelvic ultrasounds and annual blood tests to more aggressively look for indications of early cancer. “The main options are very close surveillance or surgery,” Dr. Kreider said.
For more information about the genetic testing for breast cancer, please call your physician or the Banner Summit View Medical Commons breast health nurse at (970) 395-2582.