Genetic testing for breast cancer risk


Dear Mayo Clinic: I recently was diagnosed with breast cancer at 65. I have a strong family history of the disease. However, my doctor hasn’t mentioned genetic counseling or testing. Is this something I should bring up?

A: Only 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 isn’t 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 about testing.

A 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 discrimination laws.

Testing 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.

Knowing 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.

Knowing 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 don’t want to know the results.

Whether 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



Reader Comments ...


Next Up in Living

‘American Idol’ Atlanta auditions at Infinite Energy draw first and second-round hopefuls
‘American Idol’ Atlanta auditions at Infinite Energy draw first and second-round hopefuls

“American Idol” Thursday held its final early-round auditions at Infinite Energy Arena before the three celebrity judges start vetting the talent. Patrick Lynn, the supervising producer who has overseen “Idol” auditions since the show’s launch in 2002, said in an interview that the audition date was added on the schedule...
CDC approves nasal-spray vaccine for flu season
CDC approves nasal-spray vaccine for flu season

After advising the public to avoid the nasal-spray version of the flu vaccine for the past two years, the Centers for Disease Control and Prevention is now giving it the green light. A favorite of the needle-averse, the spray did not appear to work as well against H1N1, a strain of the flu, in the past few seasons, the CDC said. But it’s expected...
HPV-related cancer rates are rising. Vaccine rates are rising, too

Cancers linked to the human papillomavirus have increased significantly over the last 15 years in the United States, with throat cancer now the most common HPV-related malignancy, according to the Centers for Disease Control and Prevention. More than 43,000 people developed HPV-associated cancer in 2015, compared with about 30,000 in 1999, the CDC...
Lab-approved ways to disaster-proof your home
Lab-approved ways to disaster-proof your home

Whether you’re an owner or a renter, stay one step ahead of fires, leaks, floods and worse with our expert advice to avoid costly repairs and keep your family safe. Four ways to fireproof the fam In a recent survey, you told us that unexpected flames are your No. 1 home concern. Follow this checklist to ease your fire fears: 1. Assess your equipment...
Huge clinical trial collapses, research on alcohol remains befuddling

Research on alcohol consumption is in a pickle. There’s no question that pounding one drink after another is bad for your health. Things get murkier when it comes to “moderate” drinking. What does that mean? What’s the limit? Can a health-conscious person serenely order a second round? The alcohol industry has long embraced...
More Stories