How genetics impact your chances of being diagnosed with breast cancer
June 5, 2023Categories: Cancer Care
Your breast cancer risk is impacted by a variety of different factors – age, reproductive history, overall health. But genetics play an important role too.
About 5 to 10% of breast cancers and 10 to 15% of ovarian cancers are hereditary, according to the Centers for Disease Control and Prevention. This means cancer may run in your family and is likely caused by a gene mutation inherited from one of your parents.
Properly functioning BRCA1 and BRCA2 genes protect you from getting breast cancer and ovarian cancer. If these genes are mutated, they can pose a huge risk of the development of breast cancer and ovarian cancer in a lifetime.
What it means to be a BRCA1 or BRCA2 carrier
About 1 in every 500 women in the United States has a mutation in either their BRCA1 or BRCA2 gene, according to the CDC. Not everyone with this gene mutation will develop cancer, but it does put you at a much higher risk.
For the general population, 1 in 8 women – or 12% -- will develop breast cancer in their lifetime. If you have the gene mutation, your risk goes up significantly – lifetime risk for breast cancer ranges from 45 to 85% risk and ovarian cancer from 10 to 46%.
Those at higher risk of having the mutation include:
- Individuals with Ashkenazi Jewish heritage.
- Individuals who have a male relative with breast cancer.
- Individuals who have a relative diagnosed with breast cancer before the age of 50.
- Individuals who have a relative with bilateral breast cancer (cancer in both breasts) or breast cancer and ovarian cancer.
The difference between BRCA1 and BRCA2
While both genes serve similar functions, there are key differences.
BRCA1 gene |
BRCA2 gene |
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Ovarian cancer is often detected at a later stage because current screening methods for it are not very effective. This is a concern for individuals with the BRCA1 gene mutation, as the technology for detecting ovarian cancer is not as advanced as it is for breast cancer.
What happens after learning you’re a BRCA carrier
Finding out you have tested positive for the BRCA gene mutation can be overwhelming. But there are options available, including increased screenings – intended to catch and treat breast cancer early – medication and surgery, either a prophylactic mastectomy or prophylactic hysterectomy.
Your doctor will look at two things – your age and if you’re done having children.
Some people want to hold off on big surgeries if they want children. In those cases, it’s recommended to increase screenings meaning a mammogram and an MRI every year followed by a clinical breast exam. We follow you in hopes we’ll find cancer when it’s smaller, which will be more easily treated.
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The drug Tamoxifen blocks estrogen and can help prevent women from developing some breast cancers. But it can cause issues for women trying to get pregnant and it’s unable to treat triple-negative breast cancer, which can develop in BRCA1 patients.
A prophylactic mastectomy is the most aggressive of the options, but it also reduces your risk of developing breast cancer by 97% percent.
Women in their 40s and 50s are more likely to opt for the prophylactic mastectomy. It’s the safest thing and many are done having children.
Whatever you may choose, your provider will help walk you through options and come up a plan.
Remember - knowing is power. We can protect you better when we know.