Mayo Clinic: I recently was diagnosed with breast cancer at
65. I have a strong family history of the disease. However, my
doctor hasnít mentioned genetic counseling or testing. Is
this something I should bring up?
about 5 to 10 percent of breast cancer cases are thought to be
hereditary, meaning that they result directly from gene
defects (mutations) passed on from a parent. For that reason,
genetic testing isnít routinely recommended. However, women
with strong family histories of breast and other related
cancers are one of the exceptions to this rule. There are
several good reasons to talk with your health care provider
genetic test involves taking a blood or saliva sample, and
analyzing your DNA for gene mutations that can increase your
risk of developing cancer. Ideally, your health care provider
will first refer you to a genetic counselor, who will collect
the family history, and discuss the risks and benefits of
genetic testing. The genetic counselor also will review other
important issues associated with testing, such as cost,
insurance coverage and your rights under genetic
may be appropriate when a woman has a personal or family
history suggesting an increased risk of breast cancer. Risks
include having cancer in both breasts, having a certain
subtype of breast cancer, or being younger than 50 when
diagnosed. Other red flags include multiple cases of breast,
ovarian or pancreatic cancer on the same side of the family;
male breast cancer; or Ashkenazi Jewish heritage.
you have a hereditary mutation can guide your treatment
decisions. For example, if you carry a high-risk mutation, you
may feel more comfortable undergoing a mastectomy, rather than
a lumpectomy. You also may want to consider preventive
surgeries, such as removal of your ovaries (oophorectomy).
Ovaries produce estrogen, which, in premenopausal women, can
feed estrogen-sensitive breast cancer. This procedure also
lowers your risk of developing ovarian cancer, which has been
linked to some of the same mutations as those that cause
hereditary breast cancer.
your genetic status may benefit your family, as well. If you
test positive for a mutation, you can share this information
with your relatives to allow them to weigh their own options.
However, family members may not want to know. Discuss your
decision to test with them and respect their wishes if they
donít want to know the results.
you decide ultimately to have the genetic test or not, you may
want to ask your health care provider to connect you with a
genetic counselor. He or she will be able to help you navigate
the risks and benefits of genetic testing.
Adapted from Mayo Clinic Health letter