Hereditary Breast Cancer


A relative having breast cancer does increase the risk of breast cancer. However, the strength of association depends on the genetic reason for the cancer. About 5% to 10% of breast cancers are thought to be hereditary. These are due to errors in the DNA that are passed on from parents. There are chances that a person could be the first in the family with this mutation.

Genes Responsible For High Risk Of Breast Cancer

The error in BRCA1 and BRCA2 genes are responsible for most of the hereditary cancers. The average woman has about a 12% risk of developing breast cancer in her lifetime. This risk increases to 80% if these genes are abnormal. These patients tend to develop cancer much younger and cancers occur more often in both. These women also have an increased risk of developing ovarian, colon, pancreatic and thyroid cancers. In addition, men with these abnormal genes have an increased risk of prostatic cancer.

Apart from BRCA1 and BRCA 2 there are many other genes that can increase the risk of breast cancer. These include abnormal ATM, CDH1, CHEK2, MRE11A, NBN, p53, PALB2, PTEN, RAD50, RECQL, or RINT1 gene. At MACS Clinic, genetic tests are available to determine if someone has these genetic abnormalities. A genetic counselor also may order testing for more genes based on your personal or family history

Who Should Undergo The Genetic Tests?

  • Breast cancer among blood relatives on your mother’s or father’s side diagnosed before age 50.
  • Single individual with both breast and ovarian cancer in your family.
  • Other gland-related cancers in your family such as pancreatic, colon, and thyroid cancers.
  • Women in the family have had cancer in both breasts.
  • A man in your family has had breast cancer.

Managing High Risk Patients

More frequent screening: The screening plan for a high risk individual with abnormal breast cancer gene has to be tailored. The screening generally starts before the age of 40. The plan involves screening tests twice in an year, alternating between a digital mammogram and an MRI scan.

Protective or prophylactic surgery: This involves removing the healthy breasts and ovaries before cancer is detected. With prophylactic breast surgery there is a 97% reduction in risk of developing breast cancer. The small risk that remains is due to few breast cells that remain in spite of mastectomy. Team of doctors at MACS clinic perform these surgeries with minimal access (laparoscopic) techniques giving almost normal look to the reconstructed breast.

Further, removal of ovary before menopause reduces the breast cancer risk by 50%. This works by reducing the hormone estrogen in blood. In addition, prophylactic removal of both ovaries and fallopian tubes reduces the risk of ovarian. Team of doctors at MACS clinic perform removal of ovary by laparoscopy making it a simple painless procedure.

Prophylactic surgery decisions require a great deal of thinking, patience, and discussion with your doctors, genetic counselor, and family. The decision requires a tremendous amount of courage.

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