Genetic counselling services give people information about their chance of developing cancer based on their family history. These specialists will spend time explaining how to be more vigilant with screening for cancer and how modifying diet and lifestyle factors may decrease risk. It may be that genetic testing is possible, particularly if a member of the family who has cancer can be tested. This is only carried out after the advantages and disadvantages of testing for the patient and their family have been discussed.
After female gender and advancing age, a positive family history of cancer is the strongest risk factor in developing breast cancer. In most cases there is not a long and extensive history of cancer present (more than four relatives in the same line). However, in some families there is a strong hereditary line of cancer characterised by cancer at a young age; cancer in both breasts, as well as clustering of different cancers of the breast (primarily ovarian and male breast cancer). Only less than 8% of all breast cancers will be due to these genes, which are known as BRCA1 and BRCA2. Others, which are less well known, are TP53, PTEN/MMAC1 and STK11. There is testing available for the BRCA 1 and 2 genes for patients with a significant family history.
Managing patients and families who have a strong family history, or a positive genetic test is highly specialised and requires a team approach to management. Close communication between breast specialists and genetic specialists and discussions about screening, early detection and risk reducing surgery should be managed only in a specialist unit. Risk reducing surgery is not โaesthetic surgeryโ but rather reconstructive, it is not as simple as โBarbie breasts for lifeโ.
Studies have shown that it is possible to reduce the number of women dying from breast cancer by 45% using simple measures. These include understanding your risk of having breast cancer based on your personal and family history and being screened regularly for breast cancer.