Do you have a family history of breast cancer? You may want to consider making an appointment with your doctor to get genetic counseling for breast cancer. The average woman has a 13% chance of developing breast cancer. Over 270,000 new cases of breast cancer surgeon are expected to develop this year, according to the American Cancer Society. Although deaths from breast cancer have decreased since 2007, it is still the second leading cause of death among women. For those who are predisposed to developing breast cancer, those risks are much higher.
What Is Breast Cancer Counseling and What Is the Role of a Genetic Counselor
Women whose family history indicates breast cancer may inherit gene mutations making them more likely to develop it. Genetic counseling for breast cancer includes a method of testing meant to identify these mutations and provide guidance on the next steps to prevention. The BRCA1 and BRCA2 genes are the most important and deadly mutations for women. Those who have it are diagnosed with Hereditary Breast and Ovarian Syndrome. Both men and women can develop breast cancer but the BRCA1 gene greatly increases the risk of breast cancer, pancreatic cancer, ovarian cancer, and others. Men with the BRCA1 are also at high risk but still lower than women. They may develop prostate cancer, pancreatic cancer, and other cancers. It’s important to note that most women do not inherit the mutation but it is more likely in a family with a history of breast cancer. Inheriting the gene mutation is more likely if a close relative had it, multiple family members were affected, and if they were young when they developed it.
Your doctor will use a number of risk assessment tools in the form of mathematical models to calculate your risk of a gene mutation. They may also refer you to another medical professional for breast cancer genetic counseling. These individuals are highly trained in genetic counseling and will inform you of what to expect during the session. The role of a genetic counselor is to help families identify the possible risk of a genetic condition by analyzing family history and patterns of inheritance. They are also trained to calculate the likelihood of an occurrence. Not all women with breast cancer need genetic counseling but the likelihood of receiving breast cancer genetic counseling is higher if:
- Diagnosis at a young age
- Second diagnosis
- Ashkenazi Jewish descent
- Family history of breast cancer, ovarian cancer, prostate cancer, or pancreatic cancer
- Family history of BRCA
- Family history of breast cancer at a young age
What Do Breast Cancer Genetic Counseling Results Look Like
Genetic counseling for breast cancer is focused on finding at least one gene mutation. During the testing phase, if no specific gene mutation is specified, testing for multiple mutations is likely. The results you receive will appear as the following:
- Positive – There are still steps that can be taken to lower your risks.
- Negative – Although a relief to receive a negative result, there is no guarantee that you are not still at an increased risk. There could be a chance that you have a mutation that you were not tested for.
- Inconclusive – In this case, the test was unable to determine whether you have a mutation.
- VUS – Positive for a variant of unknown significance is an indication that the testing identified a gene change but is not certain this affects your risk of breast cancer.
Other tests are available to the public but these tests will not be able to test for the full spectrum of possible gene mutations. They may be able to identify certain BRCA mutations but not all. This could lead to a negative result in which the individual has a different mutation.
Why Have Genetic Counseling for Breast Cancer
In a recent study on genetic counseling after a breast cancer treatment, it was noted that fewer than 50% of women who’ve been recently diagnosed received genetic counseling. For women who inherit the BCRA gene mutation, the risk of developing breast cancer is 72% and the risk for ovarian cancer is between 17 – 44%. The study results suggest that high – risk women who should be getting genetic counseling are not. Receiving timely risk evaluation, counseling, and testing can make the difference between life and death. For women who inherit the gene mutation, there are several steps that can be taken to mitigate the risk of breast cancer:
- Beginning an aggressive screening strategy at a young age
- Reduce or block the number of estrogen effects on breast tissue through hormonal therapy
This information is valuable for those in your immediate family and will help to raise awareness to take action for prevention. Additionally, women with this gene may choose to have their ovaries removed to reduce the risk of ovarian cancer. Using the Gail score, a breast cancer risk assessment tool, the risks of developing breast cancer in the next five years can be estimated. The questions are answered by both the patient and doctors while assessing family history, age, childbearing history, and biopsy results
Are There Any Risks for Breast Cancer Counseling and How Do I Prepare
Although there are no medical risks for genetic counseling for breast cancer, there may be financial, emotional, medical, and social implications. You may feel depression, anxiety, anger, and sadness if you receive a positive diagnosis. You may be concerned about how your insurance will be affected and what the financial impact will look like. Getting positive results may cause a strain in your family relationships after finding out that breast cancer runs in the family. You may have to make difficult decisions about the preventative measures you’ll need to take and what long term impact this may have. Also, you may feel that you will inevitably develop cancer and experience a sense of hopelessness.
For those who test negative or receive ambiguous test results, you may feel a sense of “survivors guilt” if your family has a gene mutation. You may also be concerned that the results are not accurate. The role of a genetic counselor also includes helping you navigate these emotions so that you come out of the other side with peace of mind. Preparing for your genetic counseling session is a simple one that requires you to do some homework. Since the genetic counselor will take a detailed account of your medical and family history, assess your cancer risk, discuss benefits, and provide options, you should have the following information ready:
- Talk to your relatives and gather as much information as you can about medical history
- Write down details about your own personal medical history and include tests conducted by specialists and or previous genetic testing
- Bring a family member or friend with you to help with questions and taking notes
- Bring a list of questions for the counselor
Your blood will be drawn for a testing sample. Sometimes, other DNA samples are taken including saliva. Your genetic counselor will indicate the appropriate test for you.
Book an Appointment Today for Genetic Counseling
Does breast cancer run in your family? Take control over your health by talking to your doctor about genetic counseling. The sooner you are informed, the better your chances are at preventing breast cancer. Breast Care Center Miami provides general and preventative services to both men and women. With over 9 years of medical experience, we are committed to providing high-quality health care. Book an appointment with us to discuss your genetic counseling options today!