Signs breast cancer may be BRCA-related

Certain patterns in your family’s health history may suggest that you or your relatives carry a gene mutation linked to breast cancer.

Research shows your family may carry a gene mutation linked to breast cancer if:

• You were young at diagnosis. Typically, breast cancer occurs in older women. The younger you are at diagnosis, the more likely the breast cancer is related to a gene mutation. National guidelines recommend BRCA testing if you were diagnosed at or before age 50
• You have a certain type of breast cancer. Triple-negative breast cancer, especially when diagnosed at a younger age, may be associated with a gene mutation
• You had two separate breast cancer diagnoses. If you had breast cancer in the past and were later diagnosed with a second, new breast cancer, a gene mutation might play a role, especially if the first cancer was diagnosed before age 50
• You have breast cancer and a strong family history of breast or ovarian cancer. Women with BRCA mutations are at risk for both breast and ovarian cancer. If there is a strong history of either in your family, inherited gene mutation might be the cause. You can inherit gene mutations from both your mother and your father

A strong family history includes:

• Several relatives on your mother’s or father’s side with breast or ovarian cancer
• One or more first-degree relatives with breast or ovarian cancer, especially if diagnosed at young ages. First-degree relatives are your parents, brothers, sisters or children
• Family members with both breast and ovarian cancer
• Any cases of breast cancer in men in your family
• A close relative with ovarian cancer. Between 5 and 10 percent of ovarian cancers are associated with a BRCA mutation
• You may also be more likely to have a BRCA mutation if you have breast cancer and your family is of a certain ethnic origin. People of Ashkenazi (Central-Eastern European) Jewish descent are almost 10 times more likely to carry a breast cancer-related gene mutation than people of other ethnic backgrounds.

What If you don't have breast cancer?

If you have not been diagnosed with breast cancer, you may still be concerned about your risk of getting breast or ovarian cancer. You may already know a gene mutation exists in your family and wonder if you carry it yourself.

National testing guidelines recommend that the first person who gets tested in a family already be diagnosed with breast cancer or ovarian cancer. If that first person tests positive, meaning that they have a genetic mutation, other family members may then choose to have testing themselves. If you and your healthcare provider believe there are other reasons to test, you may also wish to do so.

Testing positive for a gene mutation

If you test positive for a gene mutation related to breast cancer, your genetic counselor will likely recommend that you have screening more often than the average woman your age who is not at high risk.

Current American Cancer Society guidelines suggest women of average risk start yearly mammograms at age 45. The ACS guidelines say that women of average risk don’t need to get clinical breast exams or do self-exams. If your doctor follows a different guideline, they may recommend starting yearly mammograms at a different age. It’s OK to ask why they recommend a certain age and discuss any concerns you have. The main goal is for you to know what your breast usually look and feel like, so that you might notice if there are significant changes one day.

Women who test positive for a BRCA mutation follow a different screening guideline because their risk of breast cancer is higher. These screening guidelines suggest starting annual breast mammograms and MRIs at age 30.

If you have a BRCA mutation, you may choose to have surgery to help lower your risk of developing cancer. When you do not have breast cancer, choosing to remove the breasts or ovaries is considered prophylactic, or preventive. Treatment with a medicine like tamoxifen or raloxifene may also be an option, and is known as chemoprevention.