Understanding Your Breast Cancer Family History

what constitutes a family history of breast cancer

Family history is a major risk factor for breast cancer. People with a family history of breast cancer or other cancers have an increased risk of breast cancer. This risk is likely due to genetic factors but may also be due to shared lifestyle factors or other family traits. The closer the connection, the greater the risk. The number of relatives affected also affects the risk. If two first-degree relatives have been diagnosed with breast cancer, the risk increases. The risk is also higher if the relative was diagnosed before the age of 50. In the US, 5-10% of breast cancers are related to an inherited gene mutation.

Characteristics Values
Connection to the affected relative The closer the connection, the greater the risk
Number of relatives affected Risk increases with the number of affected relatives
Age of relative at diagnosis Risk is higher if the relative was diagnosed under the age of 50
Subtype of breast cancer Risk is higher if the relative had triple-negative breast cancer
Affected breasts Risk is higher if the relative had cancer in both breasts
Family history of other cancers Having a family history of other cancers increases risk
Gene mutations BRCA1 and BRCA2 gene mutations increase risk
Family history of early-onset breast cancer Having a family history of early-onset breast cancer may be a reason to consider genetic testing

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The number of relatives affected

In addition to the number of relatives, the subtype of breast cancer they were diagnosed with is also significant. For instance, triple-negative breast cancer is a particularly aggressive form, so having a relative with this subtype may indicate a stronger risk. Furthermore, the risk is higher if the relative had primary cancer in both breasts.

While family history is a significant risk factor, it is important to remember that most women diagnosed with breast cancer do not have a family history of the disease. Hereditary breast cancers tied to genetic mutations are rare, with only an estimated 5 to 10% of cases thought to be hereditary.

If an individual has a family history of breast cancer, they may consider consulting a genetic counsellor to discuss testing for gene mutations. The presence of certain mutations, such as BRCA1 and BRCA2, can significantly increase the risk of developing breast cancer. However, deciding to undergo genetic testing is a personal choice that should be carefully considered with the help of a healthcare provider.

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The relative's age at the time of diagnosis

The age of a relative at the time of their breast cancer diagnosis is a significant factor in determining an individual's risk of developing the disease. The younger a family member is at diagnosis, the higher the risk to their close relatives. If a relative is diagnosed before the age of 50, the risk to their family members is higher. If diagnosed before the age of 40, the risk is even greater.

The risk is also influenced by the degree of relation and the number of affected relatives. For instance, having a first-degree relative (mother, sister, or daughter) diagnosed with breast cancer approximately doubles the risk. If two first-degree relatives are affected, the risk increases further.

In the UK, GPs follow guidelines to identify individuals who may have an increased risk of breast cancer due to their family history. If an individual has a first-degree female relative diagnosed with breast cancer under the age of 40, or a first- or second-degree relative diagnosed over the age of 40, they may be referred to a specialist breast or genetics clinic for assessment.

In the US, the National Comprehensive Cancer Network (NCCN) recommends that individuals with a greater than 20% lifetime risk of breast cancer based on family history undergo a clinical breast exam and risk assessment every 6-12 months, starting at age 25.

It is important to note that while family history is a major risk factor for breast cancer, most women diagnosed with the disease have no family history of it, and hereditary breast cancers tied to genetic mutations are rare.

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The degree of relation

First-degree relatives, such as mothers, sisters, and daughters, are considered to be the closest connections. If a first-degree relative has been diagnosed with breast cancer, an individual's risk approximately doubles. This risk increases further if multiple first-degree relatives are affected or if the relative was diagnosed before the age of 50, particularly if they were premenopausal. In such cases, the risk of developing hereditary breast cancer is heightened.

Second-degree relatives, such as grandmothers, aunts, or half-siblings, also contribute to an increased risk, though to a lesser extent. A woman with one second-degree female relative diagnosed with breast cancer in one breast after the age of 50 is considered to be at average risk, similar to the general population. However, if more second-degree relatives are affected or if they were diagnosed at a younger age, the risk level can rise.

It is important to note that most women diagnosed with breast cancer do not have a family history of the disease, and hereditary breast cancers tied to genetic mutations are rare. While family history is a risk factor, it does not guarantee that an individual will develop breast cancer.

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The presence of gene mutations

The presence of certain gene mutations can increase the risk of breast cancer. BRCA1 and BRCA2 are genes that everyone has, and they play a crucial role in preventing cells in our bodies from growing and dividing uncontrollably. However, if there is a mutation or fault in these genes, it can lead to the uncontrolled growth of cells, potentially resulting in the development of several cancers, including breast cancer.

Families with a strong history of breast cancer often carry inherited gene mutations. Specific indicators of a strong family history include having more than one first-degree relative (mother, sister, or daughter) with breast cancer, a female relative diagnosed at a young age, or a male relative diagnosed at any age. The presence of these factors significantly increases an individual's risk of developing breast cancer.

While the presence of gene mutations can increase the risk, it is important to note that most breast cancers are not solely caused by these mutations. Researchers estimate that only around 5 to 10 out of 100 breast cancers (5 to 10%) are attributed to inherited faulty genes. This highlights the complex interplay between genetic and other factors in the development of breast cancer.

If an individual has a family history of breast cancer, it is recommended that they consult a genetic counsellor or their healthcare provider. Genetic testing can be performed to identify inherited gene mutations, such as those in the BRCA1 and BRCA2 genes. This information is valuable for understanding an individual's risk and can guide clinical management, including enhanced screening, risk-reducing surgery, or medication to mitigate the elevated risk associated with gene mutations.

Additionally, risk assessment tools, such as the Breast Cancer Risk Assessment Tool (Gail model), can be utilised to estimate breast cancer risk, even without detailed family history information. These tools, in conjunction with discussions about other risk factors, can help individuals understand their risk profile and make informed decisions about their health.

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Shared lifestyle factors

While genetic factors are a significant contributor to an increased risk of breast cancer, shared lifestyle factors also play a role. These factors can be influenced by the environment and habits cultivated within a family. Here are some examples of shared lifestyle factors that can contribute to a family history of breast cancer:

Diet and Nutrition: Eating habits are often shaped by the family environment. Families with unhealthy dietary patterns, such as high consumption of processed foods, red meat, or excessive alcohol intake, may inadvertently increase their risk of breast cancer. On the other hand, families who prioritize a balanced diet rich in fruits, vegetables, and healthy fats may lower their risk.

Physical Activity: Families that engage in regular physical activity and encourage an active lifestyle may positively impact their overall health. Regular exercise has been linked to a reduced risk of various cancers, including breast cancer. Conversely, a sedentary lifestyle characterized by minimal physical activity could be a shared lifestyle factor that increases the risk of breast cancer.

Weight Management: Maintaining a healthy weight is crucial for overall health. Obesity has been identified as a risk factor for various types of cancers, including breast cancer. Families with a history of obesity or unhealthy weight management practices may be at an increased risk. Conversely, families that prioritize a healthy body weight and practice portion control may reduce their risk.

Smoking and Substance Use: Smoking and the use of certain substances, such as tobacco or excessive alcohol consumption, are known risk factors for various cancers. If a family has a history of smoking or substance use disorders, it could contribute to an increased risk of breast cancer among its members. Families that prioritize a smoke-free and substance-free lifestyle may lower their overall risk.

Environmental Exposures: Families may share similar environments, and prolonged exposure to certain toxins or pollutants can increase the risk of cancer. For example, exposure to radiation, asbestos, or certain chemicals in the workplace or living environment could be shared lifestyle factors that influence the development of breast cancer.

It is important to note that while these shared lifestyle factors can contribute to an increased risk, they are modifiable. Making positive changes and adopting healthier habits within a family can potentially reduce the risk of breast cancer and improve overall health.

Frequently asked questions

A family history of breast cancer means that a person has one or more close relatives who have had breast cancer. The number of relatives affected and the age of diagnosis are factors that contribute to a person's risk of developing breast cancer.

Having a family history of breast cancer increases your risk of developing it. The closer the relative, the higher the risk. For example, having a mother, sister, or daughter diagnosed with breast cancer approximately doubles the risk. If a relative developed breast cancer under the age of 50, the risk is also higher.

If you have a family history of breast cancer, it is important to discuss this with your healthcare provider. They can help you understand how this impacts your risk and recommend appropriate screening plans and risk-reduction strategies. Genetic counselling and testing may also be recommended to identify any inherited gene mutations that could further increase your risk.

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