Your Inherited Breast Cancer Risk

If you have an altered gene, decisions aren’t easy to make

Finding a Genetic Counselor

For a process as sensitive as genetic testing, it’s important to choose the right facility to ensure you’re being tested appropriately and the results are correctly interpreted. Lehigh Valley Health Network’s Cancer Risk and Genetic Assessment Program is staffed by master’s-level, board-certified genetic counselors. The team includes a medical oncologist, breast surgeon, gynecologic oncologist and social worker, backed by all the resources of the health network. For more information or to make an appointment, call 610-402-CARE.

Several women in your family have had breast cancer, and now you’re wondering: Will you be next?

Your risk is definitely higher if you’ve inherited a mutation (alteration) of either BRCA1 or BRCA2, two genes linked to breast and ovarian cancers. Carrying a mutated gene doesn’t mean you’ll definitely develop breast cancer—but your chances, according to the National Institutes of Health, are three to seven times higher.

Many women decide to be tested so they’ll know where they stand and can take steps to reduce their cancer risk. Others decide they’d rather not know. “There are many things to consider before undergoing genetic testing,” says genetic counselor Ann Marie Augustyn of Lehigh Valley Health Network. “A genetic counselor can help determine if knowing your risk is the right thing for you.”

If you have your blood tested and learn that you carry the altered gene, your genetic counselor will educate and guide you in making decisions about your future. “Where you are in life—your age, if you’re finished having children, if you’re still breastfeeding—affects everything,” says Augustyn’s colleague, genetic counselor Tara Namey.

The standard of care for a woman with a breast cancer gene mutation who is over age 35 and doesn’t plan future pregnancies is to remove the ovaries. Research shows that removing them before menopause significantly reduces the risk for both breast and ovarian cancer. “The majority of women in this category choose to have this procedure,” Namey says.

About half of all women with the altered gene opt for a combination of annual mammography, annual breast MRI screening and, in some cases, a preventive drug such as tamoxifen or raloxifene. (These drugs are known to reduce breast cancer risk.)

The other 50 percent of women seek more aggressive surgical options, such as preventive mastectomy. “The unfortunate reality is that even preventive surgery can’t completely eliminate your risk, because not all at-risk tissue can be removed,” Namey says.

Clearly, deciding what to do about your inherited breast cancer risk is a very personal—and sometimes highly emotional— matter. “The right decision,” Augustyn says, “is the one that feels right to you.”

Published from Healthy You Magazine, July August 2009

This page last updated 7/12/09 07:12 PM