It can be one of the most difficult conversations you may have with your family, but with the advice from the following experts, it may just save a life.
Having a conversation about cancer and the medical history of your family is probably up there as one of the most uncomfortable and upsetting discussions you can ever have. But it’s a must, as the statistics show. Around one in seven women in Australia have a lifetime risk of breast cancer. If there is a history of breast cancer in your family, you could be at an increased risk.
What do genetics have to do with it?
This gene, called the BRCA gene increases with the number of family members who have had breast cancer.
“If you had three or more relatives the risk increases the number of family members diagnosed, first or second degree relatives and age of diagnosis,” says GP Dr Alia Kaderbhai.
A person can be at risk of carrying the BRCA1 or BRCA2 variant if:
· Several members of the family (on either side) have had breast or ovarian cancer (at least three first or second-degree relative)
· A family member has been diagnosed with both breast and ovarian cancer
· The person diagnosed was under 40 years old
· The family has Ashkenazi Jewish ancestry (from central and eastern Europe).
· A family member has been diagnosed with bilateral breast cancer
· A male family member has been diagnosed with male breast cancer.
“Remember that even if there is a history of breast or ovarian cancer in your family, it does not necessarily mean you have inherited the gene,” says Dr Kaderbhai.
Need to know
To find out if you or any family members do carry the BRCA gene you will need to get tested. “Initially your GP should check family history for cancers, in particular breast and ovarian cancers. It’s vitally important to check both sides of the family history, paternal and maternal,” says Dr Kaderbhai.
Genetic testing involves first searching for a gene mutation. The genes most commonly tested are BRCA1 and BRCA2, but there are a panel of gene mutations that are now known to increase risk. Genetic testing is usually done through a familial cancer centre or clinic. After genetic counselling, a sample of blood is usually taken from a woman in the family who has developed breast cancer or ovarian cancer. The DNA is ‘searched’ for a gene fault. Turnaround times for results vary between weeks to months depending on the lab and
whether just a few genes or the whole panel is tested. There are also risk factors including being overweight, smoking, and drinking which can contribute to the increased chance of cancers.
“If a ‘fault’ is detected, other members of your family will need to be tested to see if they also carry the gene,” says Dr Kaderbhai.
“Counselling is made available to help you decide the best course forwards. “This may include preventative measures, such as medical or surgical interventions, [such as a mastectomy], as well as an individualised screen process,” says Dr Kaderbhai. “Your multi-disciplinary team will be best to advise on this.”
For Lan Crowley, knowing her family medical history is of vital importance. “Having gone through a cancer diagnosis and its aftermath, early intervention is more than just survival. If you can prevent (or reduce the risk of) a cancer diagnosis, you won't have to undergo any cancer treatments at all: there won’t be surgery, chemotherapy, radiation, or ongoing cancer treatments to prevent recurrence. That is peace of mind for you and for your family.”
1. Cancer Australia. Advice about familial aspects of breast cancer and epithelial ovarian cancer: A guide for health professionals. Sydney: Cancer Australia, 2010 [Accessed 19 December 2017].
2. Genetic testing for breast/ovarian cancer risk (canceraustralia.gov.au)