Breast cancer runs in your family? Genetic assessment can help!

Your genes determine more than your blood type and physical features-they may also determine your risk for developing certain diseases, including cancer. Some families have an inherited tendency to develop certain types of cancer. In these families, a change in the genetic material (called as a germ-line mutation ) , or DNA, predisposes those who carry it, to developing cancer. This germ-line genetic mutation may be passed down from parent to child.

Several relatives with cancer in a family is often an indication that there may be inherited predisposition to cancer, putting healthy individuals of that family at a 1 in 2 risk of developing certain types of cancers. Cancers in such families typically occur at younger ages than in the general . Sometimes people in these families develop more than one cancer. If you're facing inherited cancer risks, there's experienced help available in India. A specialized Genetics Consultation helps in identifying whether a cancer is hereditary, and if yes, what can be done to prevent it from developing.

You should seek a specialized genetic consultation if you have:

Several family members with cancers
Cancers in 2 or more generations in your family
A relative with a confirmed cancer genetic mutation
Early-age onset of adult cancers; family members diagnosed at younger ages than in the general ( eg. below 35 years of age for breast cancer, or in the 40s for colon cancers)
Family members with cancer in more than one location (not a spread, or metastasis) ie. in two different or paired organs
Other unusual conditions such as skin markings, or growths alongwith a cancer diagnosis
Genetic disorders in cancer patient or family
Rare or unusual cancers
Concerns about hereditary issues related to cancer

Before the initial clinic visit, you will be asked to fill out a questionnaire with questions exploring your personal medical history, family cancer history, and additional cancer risk factors. With this information, your detailed family pedigree is charted with which, based on established computer models, we assess your cancer predisposition risk, and therefore this information is extremely important for your evaluation. Patients are required to carry as detailed information as possible for an accurate risk assessment

For any relative with a history of cancer, the following information is collected:

Primary site of each cancer, with supportive documentation of key cancers to confirm primary site and histology (e.g., pathology and CT/MRI reports, surgical reports)
Age at diagnosis for each primary cancer
Where the relative was diagnosed and/or treated
History of surgery or treatments that may have reduced the risk of cancer
Current age (if the individual is living)
Age at death and cause of death (if the individual is deceased)
Carcinogenic exposures (e.g., tobacco use, radiation exposure)
Other significant health problems

For relatives not affected with cancer, the following information is collected:

Current age
History of any surgeries or treatments that may have reduced the risk of cancer
Cancer screening practices
Any nonmalignant features associated with the syndrome in question
Carcinogenic exposures
Other significant health problems

Based on answers to the above queries, option of genetic testing is discussed and personalized medical recommendations for early detection, risk reduction and prevention, lifestyle modifications are made. Your concerns regarding risk to relatives, child-bearing, and any other hereditary issues are addressed.

Following the consultation, your cancer risk assessment is provided to you and your referring physician, outlining your personal and family cancer histories, an assessment of the likelihood of an inherited risk for cancer in the family, any genetic testing advised to confirm the risk status, and guidelines for early detection and prevention of cancer.

Even if you have inherited the familial mutation, it is not inevitable that you will develop cancer. Diet and lifestyle modification, preventive medicine (known as chemo-prevention) or preventive surgery may help lower the risk or prevent cancer altogether. You may also benefit from beginning cancer screening at an earlier age, screening more frequently, or screening by other methods that are not recommended for someone at average risk. This way, even if you do develop cancer, it is more likely to be caught at an earlier stage, when treatment is more effective and outcomes, better.

Read more about causes, symptoms, diagnosis and treatment of breast cancer.

Sometimes the cancers in a family are caused by genetic factors that cannot be detected with current testing methods or by a mix of genetic and environmental factors. For this reason, a negative genetic test result does not always mean that there isn't an inherited risk in the family. At times, increased screening, preventive medicine or surgery may be considered even if genetic testing is not done, or is uninformative (meaning that no genetic mutation was found).

There is a popular misconception that if the breast cancer (and/or ovarian cancer) in the family is on the father's side, it does not matter.This is not true. Having a cancer history in your fathers' side of breast and/or ovarian cancer can have a significant impact on your risk. Both mothers' and fathers' family cancer histories are very important for determining your personal cancer risks. Having a mutation in one of the breast and ovarian cancer genes has a larger impact on cancer risks for women than for men. It is not uncommon for a man to carry a mutation in one of the breast and ovarian cancer genes and never develop cancer himself. However, he can pass this mutation on to his children, including his daughters.

The other misconception is that familial cancers affected only members of a certain sex, which means that if men have historically had cancers, only men will be affected and likewise for women. This isn't true again and may be attributed to chance alone. The genetic mutation could be carried by either father or mother, and are cancer risks for both males and females who carry the genetic mutation.

Read more about causes, symptoms, diagnosis and treatment of cancer.

Also read: War on Cancer

For more information visit, www.breastcancerindia.net

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