Understanding Breast Cancer Risk Factors: Personal Health History

Understanding what factors in your personal health history might affect your risk can help you work with your doctor to address any concerns you may have and develop a breast cancer screening plan that is right for you.

• High bone density, age at first period, age at menopause, current or recent use of birth control pills and menopausal hormone use all are linked to blood estrogen levels which can impact breast cancer risk.

• Women who have had ovarian cancer appear to have an increased risk of breast cancer.

• Women who have an inherited mutation in the BRCA1 or BRCA2 gene have an increased risk of both breast and ovarian cancer.

• Breast cancer survivors have an increased risk of getting a new breast cancer. If the first breast cancer was hormone receptor-negative, the risk may be higher compared to those survivors whose first breast cancer was hormone receptor-positive.

• Those with a history of Hodgkin’s disease in childhood or early adulthood are about 8 to 25 times more likely to get breast cancer.

 

Breast Cancer Education: Genetic Testing for Those at Higher Risk of Breast Cancer

Family history and some inherited genetic mutations affect breast cancer risk in both men and women. Having an immediate family member (a parent, sibling or child) with a history of breast cancer increases your own risk of breast cancer.

You should know, however, that genetic mutations linked to breast cancer are rare in the general population. Not all men and women with a family history of breast cancer are likely to have a known genetic mutation. Inherited gene mutations account for only 5 to 10 percent of all breast cancers diagnosed in the U.S.

Mutations are changes in the genetic code of a gene that affect its function. Inherited gene mutations can be passed on from a parent to a child. Some inherited gene mutations increase breast cancer risk.

Genetic testing gives people the chance to learn if they carry a gene mutation that increases their risk of developing breast cancer.

BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) are the most well-known genes linked to breast cancer.

People who have a BRCA1/2 mutation have an increased risk of breast cancer and (for women) ovarian cancer. Although genetic testing for BRCA1/2 is widely advertised, testing is only recommended for certain people, including those with:

• A known BRCA1/2 gene mutation (or other inherited gene mutation linked to breast cancer) in the family
• A personal history of breast cancer at age 50 or younger
• A personal history of breast cancer at any age and a family member (parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew, niece or first cousin) diagnosed with breast cancer at age 50 or younger
• A personal history of breast cancer and Ashkenazi Jewish heritage
• A personal history of triple negative breast cancer (breast cancer that is estrogen receptor-negative, progesterone receptor-negative and HER2-negative) diagnosed at age 60 or younger
• A personal or family history of ovarian cancer
• A personal or family history of male breast cancer

A family member (parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew or niece) diagnosed with breast cancer at age 45 or younger

There is only a very small chance that your family carries a BRCA1/2 mutation if:

• You or an immediate family member is the only person in your family with breast cancer

• The breast cancers in your family all occurred at older ages

In most cases, genetic testing is not recommended when there is a low chance of finding a mutation.

Remember that most breast cancers are not due to a BRCA1/2 mutation. Although BRCA1/2 gene mutation testing is a simple blood test, the risks and benefits should be considered before testing. There are potential physical, emotional and financial impacts of knowing your genetic status. Thus, testing for the BRCA1/2 mutation is recommended only for people who fall into one of the categories listed above.

Genetic counseling and BRCA1/2 testing

Genetic counselors

It is strongly recommended that you speak with a genetic counselor (or other health care professional trained in genetic counseling) before deciding whether to be tested for a BRCA1/2 or other gene mutation. Only people who meet the criteria above should consider testing. A genetic counselor can help you determine whether you meet these criteria. He or she can also discuss the benefits and risks of testing (more on these issues) with you.

For more information on genetic counseling, visit the National Cancer Institute’s website (or call its hotline at 1-800-4-CANCER) or the National Society of Genetic Counselors’ website.

A doctor or genetic counselor can help you decide whether genetic testing is appropriate for you or your family members. For more information on genetic counseling, visit the National Cancer Institute’s website (or call its hotline at 1-800-4-CANCER) or visit the National Society of Genetic Counselors’ website.

For more information on inherited gene mutations, visit: http://ww5.komen.org/BreastCancer/GeneMutationsampGeneticTesting.html

Learn more: http://ww5.komen.org/uploadedFiles/_Komen/Content/About_Breast_Cancer/Tools_and_Resources/Fact_Sheets_and_Breast_Self_Awareness_Cards/Genetics%20and%20Breast%20Cancer.pdf

Hereditary breast cancer: http://ww5.komen.org/uploadedFiles/_Komen/Content/What_We_Do/We_Fund_Research/Your_Research_Dollars_at_Work/2015%20Research%20Fast%20Facts%20-%20Hereditary%20Breast%20Cancer.pdf

Breast Cancer Education: Genetic Testing

Family history and some inherited genetic mutations affect breast cancer risk in both men and women. Having an immediate family member (a parent, sibling or child) with a history of breast cancer increases your own risk of breast cancer. You should know, however, that genetic mutations linked to breast cancer are rare in the general population. Not all men and women with a family history of breast cancer are likely to have a genetic mutation. Inherited gene mutations account for only five to 10 percent of all breast cancers diagnosed in the U.S.

Mutations are changes in the genetic code of a gene that affect its function. Inherited gene mutations can be passed on from a parent to a child. Some inherited gene mutations increase breast cancer risk.

Genetic testing gives people the chance to learn if they carry a gene mutation that increases their risk of developing breast cancer.

BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) are the most well-known genes linked to breast cancer.

People who have a BRCA1/2 mutation have an increased risk of breast cancer and (for women) ovarian cancer. Although genetic testing for BRCA1/2 is widely advertised, testing is only recommended for certain people, including those with:

• A personal history of breast cancer at age 50 or younger

• A personal history of triple negative breast cancer (breast cancer that is estrogen receptor-negative, progesterone receptor-negative and HER2/neu receptor-negative) diagnosed at age 60 or younger

• A personal or family history of male breast cancer

• A personal or family history of bilateral breast cancer (cancer in both breasts)

• A personal or family history of ovarian cancer

• A parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew, niece or first cousin diagnosed with breast cancer at age 50 or younger

• A family member (parent, sibling, child, grandparent, grandchild, aunt, niece or first cousin) diagnosed with ovarian cancer at any age

• A family history of both breast and ovarian cancers on the same side of the family (either mother’s or father’s side of the family)

• Ashkenazi Jewish heritage and a personal or family history of breast or ovarian cancer

There is only a very small chance that your family carries a BRCA1/2 mutation if:

• You or an immediate family member is the only person in your family with breast cancer

• The breast cancers in your family all occurred at older ages

In most cases, genetic testing is not recommended when there is a low chance of finding a mutation.

Remember that most breast cancers are not due to a BRCA1/2 mutation. Although BRCA1/2 gene mutation testing is a simple blood test, the risks and benefits should be considered before testing. There are potential physical, emotional and financial impacts of knowing your genetic status. Thus, testing for the BRCA1/2 mutation is recommended only for people who fall into one of the categories listed above.

A health care provider or genetic counselor can help you decide whether genetic testing is appropriate for you or your family members. For more information on genetic counseling, visit the National Cancer Institute’s website (or call its hotline at 1-800-4-CANCER) or visit the National Society of Genetic Counselors’ website.

For more information on inherited gene mutations, visit: http://ww5.komen.org/BreastCancer/GeneMutationsampGeneticTesting.html

and

http://ww5.komen.org/uploadedFiles/_Komen/Content/What_We_Do/We_Fund_Research/Your_Research_Dollars_at_Work/2015%20Research%20Fast%20Facts%20-%20Hereditary%20Breast%20Cancer.pdf

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

A Survivor’s Story: A New Way to Fight Cancer

Guest Writer: Rhiannon Reynolds Chavez, two-time breast cancer survivor and Komen St. Louis volunteer from Belleville, IL

My mother was 38 when she was diagnosed with breast cancer in 1990, and it was unexpected to say the least. She was young and our family did not have a history of breast cancer. My breast cancer diagnosis came when I was 27. I knew I carried a higher risk for breast cancer, but the results were still shocking.

Rhiannon Reynolds Chavez, two-time breast cancer survivor and Komen St. Louis volunteer

I figured we must have some genetic predisposition for breast cancer. In December 2005, during my treatment at Saint Louis University Hospital, Dr. Suzanne Mahon submitted a genetic sample to determine if I had one of the BRCA genes linked to breast cancer.

Two weeks later I was reluctantly ready to hear their findings. I knew I was going to be positive for one of the BRCA genes. I knew it was good to have as much information as possible, and yet I knew I would be upset to see it on paper. I opened the envelope with Dr. Mahon ready to interpret the results.

The lab found nothing. There were no genetic markers indicating that I would be at risk for breast cancer.

I looked at Dr. Mahon, she looked at the results, frowned and said, “I think we just haven’t advanced far enough yet. I believe your cancer is genetic, we just don’t know where to look for it yet.”

Frustrated and angry that I had no answers as to why my mother and I had the same type of breast cancer, I tried to put it in the back of my mind. I continued aggressive treatment and focused on recovery. My hair started to grow back, I got a new job, I bought a house, I got married.

Seven years later, at the age of 34, my breast cancer returned. Dr. Mahon informed me that cancer researchers and geneticists had made significant advances since I had last seen her frowning at my results. I was encouraged that there were many more DNA areas to look at. So I again swabbed the inside of my cheek, swished with mouthwash and sent in the sample, with my health insurance covering the cost.

Two weeks later Dr. Mahon told me, again, there was nothing to indicate a genetic predisposition for cancer. Disappointed and irritated, we carried on the same conversation from seven years before; it’s probably genetic, there’s still a lot we don’t know, etc.

Dr. Mahon then said, “There are places some researchers are looking at, it’s pretty new and your insurance may not cover it, but I think it’s worth a shot.” Intrigued but doubtful, I hung up the phone. If my insurance wouldn’t cover this, could I afford paying out of pocket? Would I have to wait for years for health insurance to catch up?

Two weeks later Dr. Mahon called, but this time our conversation was very different. She was able to have the lab run new tests. That third test found the answer I had been looking for since 2005.

Now my doctors and I know what we’re fighting. I know that I’m at risk not only for breast cancer, but other cancers as well. It’s scary, but knowledge is power.

Now I get additional screenings each year.

Now my cousins, even distant ones, can speak more confidently about their own health.

Now I know my son will need to be tested when he’s an adult.

I am so grateful that Susan G. Komen St. Louis granted funding to Dr. Mahon in 2012, and that she armed me with a new way to fight cancer. I am constantly encouraged by the advances in breast cancer treatment. My hope is that cancer treatment continues to become more and more refined so oncologists can isolate the cause and effectively treat each patient with a direct, targeted approach. I believe we can find a way to fix or turn off genes that cause cancer.

This is why I choose to volunteer with the Susan G. Komen St. Louis Affiliate. As a member of the Komen St. Louis Young Professionals, I can serve as an ambassador in our community, sharing my story and making sure other young women and men are aware of the resources in St. Louis. We work together year-round to raise awareness and funds for Komen St. Louis, ensuring support for critical breast health programs in St. Louis.

Rhiannon is a member of the Komen St. Louis Young Professionals and also volunteers on the committee for Komen St. Louis’ inaugural Trivia Night, taking place on January 17.

Breast Cancer Research: Triple Negative Breast Cancer

About 15 to 20 percent of breast cancers diagnosed today in the U.S. are triple negative breast cancers (TNBC). These tumors tend to occur more often in younger women and African American women.

Women who carry a mutated BRCA1 gene tend to have breast cancers that are triple negative. Triple negative tumors are often aggressive. Today there are no targeted therapies specifically for TNBC. However, triple negative breast cancer can be treated with surgery, radiation therapy and chemotherapy.

More research is needed to better understand how this cancer develops and how it can be treated more effectively. And that is what Susan G. Komen® is doing.

Komen has invested more than $74 million in more than 100 research grants focused on triple negative breast cancer since it was first identified as a distinct type of breast cancer in 2006. This research has helped us to understand that:

• There are at least 6 different subtypes of TNBC, each with different abnormalities, which may be treated using drugs that are specific to these abnormalities.

• A combination of a new drug that targets a “death receptor” in TNBC cells and standard chemotherapy may be more effective at killing TNBC than chemotherapy alone.

• A blood test that measures the presence of a specific set of genes may be used to identify TNBC patients with BRCA mutations, resulting in earlier intervention and improved treatment.

Learn more: http://ww5.komen.org/BreastCancer/TripleNegativeBreastCancer.html

We’re celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use the hashtag #bcjourney to join in the conversation.

A Previvor’s Story: Joanne Kelly

A previvor is a survivor of a predisposition to cancer.

It takes courage to undergo genetic testing and uncover one’s risks for developing breast cancer. And it takes courage to process all of the complexities of cancer and still encourage others to take action. Joanne Kelly, a breast and ovarian cancer previvor, possesses the courage to go through all this and still maintain a positive outlook.

Joanne Kelly

Joanne has lived with the possibility of developing cancer ever since her mother was diagnosed with breast cancer and her aunt was diagnosed with ovarian cancer.
Approximately five to 10 percent of breast cancers in the United States are linked to an inherited genetic mutation. Despite knowing her risk early on, it was not until years later that Joanne decided to proceed with genetic testing.

“When I was 20, I did not want to have the test done; I did not want to know,” says Joanne. “As I matured in my career as an oncology nurse, I wanted to know the risk.”

Following the advice of a coworker, Joanne spoke with Suzanne Mahon, founder of the Hereditary Cancer Program at Saint Louis University Cancer Center and a Komen St. Louis grant recipient. Once the two met for genetic counseling, Mahon coordinated the genetic testing, Joanne’s mother was tested first, and the testing revealed she carried the BRCA1 mutation. Subsequent test results determined Joanne also carried this genetic mutation.

“It is very, very important to have genetic counseling before you have genetic testing done. It’s a big piece of information for the rest of your family, for your children and your children’s children,” says Joanne. “To have someone help you process that information is important. I kind of knew my risk already with my family history. To know for sure was certainly overwhelming. It was also very empowering to know that I could hopefully prevent cancer.”

Devastated yet emboldened by the news of her risk of developing cancer, Joanne decided to take action. She opted for a double mastectomy in 2008 and a hysterectomy/oophorectomy in 2010.

“Having surgery has taken away the cloud over my head,” says Joanne. “It’s been four years since I’ve had the mastectomy. Prior to the surgery, I had the internal struggle of dealing with having cancer down the line.”

Through it all, Joanne credits her husband and children with keeping her going. With their support, she has been empowered to share her experience as she educates and empowers other women.

“What motivates me are the hundreds of women who will come after me,” says Joanne. “I want to be an example that knowledge is power. I can be a voice to encourage women to know their risk, to know that it’s going to be OK.”