Family History Raises Breast Cancer Risk
Study Shows Increased Risk Even Without Gene Mutations Linked to Breast Cancer
Options for Women With Family History of Breast Cancer continued...
Narod adds, "Despite the negative test [for the BRCA mutations], women are not in the clear."
He says he recommends that women without the BRCA mutations who have three or more relatives with breast cancer should undergo MRI screenings and consider taking tamoxifen. The findings do not call for preventive surgery -- removal of the breasts -- but he says some women may wish to consider that option.
"I think we have to take tamoxifen more seriously as a society" as a preventive measure, Narod tells WebMD. "You can reduce the risk from 40% to 20% -- pretty dramatic figures. Any woman at 40% risk of breast cancer should seriously consider it."
But researchers say they aren't ready yet to recommend that all women with family histories of breast cancer get tested for the BRCA genes.
"It is a personal decision about whether or not to have genetic testing," Metcalfe says. "However, for women with a family history of breast cancer, genetic testing can offer information about their personal risk of developing breast and ovarian cancer. And if a woman is found to have [the BRCA genes], options are available to significantly reduce their risk of cancer."
Metcalfe says the Toronto study, presented at the American Association for Cancer Research's 7th annual International Frontiers in Cancer Prevention Research meeting in Washington, should make high-risk women more knowledgeable about their options.
"My opinion, if you're at high risk, take tamoxifen or raloxifene, go for an annual MRI screening, but more study is needed," Metcalfe says.
Debbie Saslow, PhD, director of breast and gynecologic cancer for the American Cancer Society, says it's important for women with a family history of breast cancer but no genetic markers to know they "are still at increased risk. That's significant."
She says the study suggests other genes, yet to be identified, put women at higher risk for breast cancer.
"If you have a family history, even if BRCA is not responsible, these women should still be considered at high risk and have preventive measures," Saslow tells WebMD. "Women with family history of breast cancer should start screening early, with MRI as well as mammography," she says. "We don't have a lot of data for women with a family history who test negative for BRCA."
She says women with family history of breast cancer should start screening at age 30 and make sure their doctors know they have relatives who've been diagnosed.
"Genetic testing is not for everybody," Saslow says. "But counseling can help a woman make an informed decision."
The American Cancer Society says many clinical studies have shown that tamoxifen and raloxifene may reduce the risk of breast cancer in high-risk women.