THE GRH BREAST CARE WEB SITE Breast Cancer in Families If you have a strong family history of breast cancer i.e. 2 or more relatives developed breast cancer or a close relative developed it at a young age, your doctor may refer you. Before you come please try and find out as much as you can about your amily history - ages of diagnosis of breast cancer, ages now, whether the cancer was in one breast or both, is there any history of ovarian cancer in the family as well etc. We will discuss with you whether you have an increased risk of developing breast cancer and give you an idea of how high that risk is. If you are at increased risk, as measured by certain criteria, we will offer you screening which usually will mean a mammogram every 18months. You may also be offered a referral to a clinical geneticist. What is genetic predisposition to breast cancer and how common is it? Every cell in our body contains two copies of all our genes, and these control how we develop (e.g. the colour of our eyes). When a cell changes into a cancer cell, several changes have occurred in both copies of these genes which result in unchecked growth of the cell. In most people who develop cancer, these genetic changes only occur in the cancer cell itself however, in rare instances a change in one copy of the gene is inherited. These individuals have an increased risk of cancer development, and as half of all genes from each individual are passed to their children, there is a risk (50:50) of passing on the abnormal gene which carries an increased cancer risk. More than one genetic change is necessary to form a cancer cell and the presence of a cancer-predisposition gene does not mean that cancer will develop, but the cancer risk is increased. About 5-10% of breast cancer cases arise in individuals who have inherited a breast cancer predisposition gene. Who is likely to carry a breast cancer predisposition gene? Women who have a family history of breast and/or ovarian cancer have a higher chance of carrying a breast cancer gene. The risk rises as the number of cases in the family increases, if the breast cancer occurred at a young age (less than 50 years) or if women have had breast cancer in both breasts. How does screening work? Screening cannot prevent breast cancer. It can, however, detect its presence before any lump can be felt within the breast. Many studies have shown that by detecting breast cancer early in this way, the treatment of the cancer is more successful and survival is improved. The NHS Breast Screening Programme offers conventional X-ray mammography to women over 50. This is because women in this age group are likely to be past their menopause, which has the effect of reducing the density of the breasts. This means that the X-rays taken of the breasts are clearer and more likely to detect any cancer which may exist. What do I do if I am concerned about my family history of breast cancer? Most women with a family history will still not be at greatly increased risk of developing the disease. Those with 4 or more relatives with breast or ovarian cancer occurring younger than 60 are at most risk. If you are worried about your family history, you can ask your GP to refer you to the breast surgery clinic or the genetics service. Homepage