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

Wes Moss: 3 traits of the happiest retirees
Wes Moss: 3 traits of the happiest retirees

I am fascinated by what makes the happiest retirees tick. Early in my almost 20-year career as a Certified Financial Planner, I realized that many people have misconceptions about what creates true enjoyment during the retirement phase of life. One statistic really struck me as I pondered the true source of happiness in retirement. A Princeton...
‘The Real Housewives of Atlanta’ part 3 reunion recap: bye bye Kim?
‘The Real Housewives of Atlanta’ part 3 reunion recap: bye bye Kim?

Posted Sunday, April 22, 2018 by RODNEY HO/rho@ajc.com on his AJC Radio & TV Talk blog Virtually the entire finale reunion episode of season 10 of “The Real Housewives of Atlanta” was all about going after Kim Zolciak. For anyone who dislikes Kim, this was a satisfying delight. (And anyone who knows me...
First live ‘American Idol’ show: top 14 perform
First live ‘American Idol’ show: top 14 perform

Posted Sunday, April 22, 2018 by RODNEY HO/rho@ajc.com on his AJC Radio & TV Talk blog I am live blogging the first live show of “American Idol” show of the season and first in two years. This will be the top 14, which will be quickly cut to 10 tomorrow. I just adopted a toddler from South Korea and have...
What is Earth Day? 5 things to know
What is Earth Day? 5 things to know

Sunday is Earth Day 2018, and more than one billion people across the globe are expected to celebrate with environmentally friendly events. But what exactly is Earth Day? Here's what you need to know: >> Read more trending news  The first Earth Day celebration took place 48 years ago, in 1970, after a devastating oil spill in America brought...
Concert review and photos: Pink flies high with dazzling return to Atlanta
Concert review and photos: Pink flies high with dazzling return to Atlanta

BY MELISSA RUGGIERI/AJC Music Scene (This review was originally posted at 1:25 a.m. on April 22, 2018) Think what you want about Pink, but don’t doubt her integrity – as a musician, a performer, a humanitarian. She’s as real as it gets. So yeah, you try this while singing. Pink apparently has no problem! Photo: Melissa Ruggieri/AJC...
More Stories