How do you know if you have a strong family history of breast or ovarian cancer?
Your doctor will ask questions about you and your
health and about your family's health to see how strong your family history is.
If you are considering having a gene test, your doctor will send you to a
genetic counselor. This expert will help you understand your chances of getting
cancer and help you decide whether to be tested.
Jewish women are
more likely to be BRCA gene carriers. Some experts recommend gene tests for
women who are Ashkenazi Jews (Jews whose ancestors came from Eastern Europe) if
they have one or both of the following:2
- Any first-degree relative with breast or ovarian cancer.
First-degree relatives are parents, sisters and brothers, and
- Two second-degree relatives on the same side of the
family with breast or ovarian cancer. Second-degree relatives are aunts and
uncles, nieces and nephews, and grandparents.
If you are not Jewish, some experts recommend a gene test
if you have one or more of the following:2
- Two first-degree relatives with breast cancer, one of whom was
diagnosed before age 50
- Three or more first- or second-degree
relatives with breast cancer, diagnosed at any age
- Both breast and
ovarian cancer in the family
- A first-degree relative with cancer in
- Two or more relatives with ovarian
- One relative with both breast and ovarian
- A male relative with breast cancer
When you and your doctor or counselor have looked at the
details of your family history, you will have an idea of how high your risk is.
That will help you decide whether to have a BRCA gene test.
What are the risks of having a BRCA test?
- The test result won't give you a clear action
plan. If your test result is abnormal (called positive), it means BRCA gene
changes are present. You will have to think about your options and decide what
to do. This can be a much harder decision than deciding whether to have the
- BRCA gene testing can cause a lot of emotions.
- If you test positive, you may feel depressed, afraid, or very
- If you test negative, you may have a false sense of
security. You may not get regular checkups and tests that help find cancer at
an early stage. A negative BRCA test does not mean that you won't get breast or
- If you test negative and someone else in
your family has breast cancer or tests positive, you may feel guilty.
- You may worry about how the test results will affect your
relationships. If you test positive, you would have to decide if you would tell
other family members, who would then have to decide whether to be
- Some people worry that a positive test would
show up on medical records and affect their ability to get medical insurance or
life insurance, or to get a job.3
If you have a family member who has breast or ovarian
cancer, think about asking that family member to have a gene test first. If
your relative's test shows that she has a changed BRCA gene, that specific
change is called a "known mutation." You and other family members can then be
tested for that specific gene change.
What can you do if your test result is positive?
If you test positive for a BRCA gene change, you will face hard decisions
about what you should do next. To lower your chances of getting cancer, your
- Get regular checkups 2 to 4 times a year and a
mammogram or other imaging test once a year. Be sure
to tell your doctor if you notice anything unusual in your
- Have surgery to remove your breasts. Studies show that this
surgery can lower your chance of getting breast cancer by 90%.4
- Have surgery to
remove your ovaries. After this surgery you will not be able to get pregnant,
but studies show that this surgery may lower your chances of getting breast
cancer. It may also lower your chances of getting ovarian cancer by more than
95%.5, 6, 7
- Take medicine.
Tamoxifen is a drug that is often given to women who have been treated for
breast cancer to help keep the cancer from returning. Not enough studies have
been done to show if this drug lowers the chances of breast cancer in women
with BRCA changes. Another drug, raloxifene, is also being studied for lowering
the risk of breast cancer.
- Take birth control pills to lower the
risk of ovarian cancer.
- What should I do if I'm at high risk for breast cancer?
- Should I have my ovaries removed to prevent ovarian cancer?
If you need more information, see the topic
Breast Cancer or