About 5-10% of all cancers are hereditary. This means that they are caused by an inherited gene mutation that can be passed through the family, either from the father’s side or the mother’s side.
Another 10-20% of cancers are considered familial, which means there may be a clustering of cancer in the family, but no genetic link is identified.
According to the United States Preventive Services Task Force (USPSTF), anyone suspected of having a hereditary risk of cancer should be offered genetic counseling.
Genetic counseling & genetic testing
Jordan Hunter, a certified genetic counselor at Piedmont Atlanta’s Helen S. Carlos High-Risk Breast Clinic, explains that there are several indicators to pursue genetic testing for hereditary cancer. For example, individuals with a family history of breast cancer diagnosed at a young age (age 50 or younger) or in multiple relatives may be eligible for genetic testing. Other cancers such as ovarian, pancreas, prostate and colon cancer can also be linked to common breast cancer genes.
“Genetic testing has expanded over the years,” Hunter explains. “When genetic testing first became available, we were only testing for the BRCA1 and BRCA2 genes. These days, we can offer larger panel genetic tests to include a number of other genes associated with hereditary breast cancer and other cancers.”
A genetic counselor can review your family history, genetic testing options, and genetic testing results. Genetic testing looks for genetic mutations that may predispose families to breast cancer or other cancer types. A genetic mutation does not mean someone will develop cancer; it does mean the risk of developing certain cancers is higher than average. Knowing about higher risk allows your healthcare team to tailor cancer screening recommendations to stay ahead of the risk.
How to be proactive about breast cancer risk
Women should start having discussions with their healthcare provider about their breast health and breast cancer risk by age 25. This includes an evaluation of the family's history of cancer, risk reduction counseling and teaching women to be aware of changes to their breasts. Men should also be aware of their risk of breast cancer.
“Most women assigned female at birth (AFAB) should begin having an annual mammogram at age 40. However, some women may have a higher risk of developing breast cancer due to personal risk factors, family history, or genetic predisposition and may be eligible for more advanced or earlier screenings,” says Lori Plummer, Women’s Health Nurse Practitioner at the Helen S. Carlos High-Risk Breast Clinic.
Women at high risk of developing breast cancer may be eligible for:
- Annual screening with breast MRI in addition to their mammogram
- Whole breast ultrasound for those who cannot undergo an MRI
- Use of medications that decrease the risk of breast cancer
- Risk-reducing surgery
“Unfortunately, we cannot change our DNA,” Plummer says, “but there are ways that we can reduce our risk of cancer by changing the way that we take care of our bodies.”
Evidence shows that the following lifestyle modifications are effective in reducing the risk of breast cancer:
- Maintain a healthy body weight (BMI 20-25) – Evidence shows that obesity increases the risk for cancer.
- Get regular exercise – Get 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity activity each week (or a combination). Getting to or exceeding the upper limit of 300 minutes is ideal.
- Limit alcohol consumption – Even just one drink daily elevates breast cancer risk! The best risk reduction is to avoid alcohol completely.
- Breastfeed if possible – Data suggests that for every 12 months that a woman breastfeeds, she can reduce her breast cancer risk by 4%.
- Limit use of combined hormone replacement therapy (HRT) – Using HRT containing estradiol and progestin for more than 3-5 years can increase a woman's risk of breast cancer.
The Helen S. Carlos High-Risk Breast Clinic at Piedmont Atlanta Hospital can help individuals learn about genetic testing and their breast cancer risk. An appointment with the High-Risk Breast Clinic includes a visit with a genetic counselor and nurse practitioner for a detailed discussion of family history and genetic testing, breast cancer risk assessment and creation of a tailored breast health plan. For more information about the Helen S. Carlos High-Risk Breast Clinic, call 470-947-6905 for additional details or to schedule an appointment.
High-risk breast services are available across the Piedmont system. Contact your local provider for a referral to the Piedmont Cancer Genetics Program and/or a breast specialist.