Do you have a strong family history of breast, ovarian, pancreatic or prostate cancer or an early cancer diagnosis yourself? If so, you may have a hereditary predisposition to cancer that puts you at greater risk of developing the disease. The first step in learning more about your possible risk of a hereditary cancer syndrome is to undergo genetic counseling.
Who Should Undergo Genetic Counseling?
You can benefit from genetic counseling if you have a personal or family history of the following:
- Onset of cancer before the age of 50
- Multiple new cancers in the same person
- Ovarian cancer
- Similar or related cancers in close relatives or family generations
- Ashkenazi Jewish ancestry and a personal or family history of breast, ovarian, pancreatic or prostate cancer
Genetic counseling and consideration of genetic testing may benefit individuals with and without a cancer diagnosis. If an analysis of your family history is suggestive of a hereditary cancer syndrome, genetic counseling may provide information that can benefit both you, your family members and future generations.
What to Expect
A consultation with a certified genetic counselor will help you understand the benefits, risk and limitations of genetic testing. However, it will not obligate you to pursue testing. Keep in mind that the information gained from genetic testing may help you and your relatives make informed decisions regarding cancer prevention and early detection.
While genetic testing consists simply of a sample of your blood or saliva, the issues surrounding genetic testing are more complicated. “The consequences of various results should be considered with the guidance and support of a genetic counselor,” says Nancy Cohen, MS, CGC (Certified Genetic Counselor), at Northern Westchester Hospital’s Cancer Treatment and Wellness Center. “Patients benefit from meeting with a counselor who reviews personal and family history, determines appropriate testing options and explains the recommendations for those found to have a hereditary predisposition to cancer.”
What If You Test Positive?
If test results show that you have hereditary cancer syndrome, knowing this information may help you and your relatives make informed decisions regarding cancer prevention and early detection. Your genetic counselor will discuss cancer surveillance and prevention options and any steps you may take to reduce cancer risk. The genetic counselor may also discuss the implications of the test results for your relatives and how to decrease the chance of a particular genetic condition occurring in future generations. Your physician can then work with you to create a cancer surveillance and/or risk reduction plan specifically for you.
Katz Institute for Women’s Health is here to answer your questions about genetic counseling and testing for breast cancer risk. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.
While breast cancer still remains one of the leading causes of death in females, significant advances in detection and treatment are helping women of all ages.
- Early Detection
- Approximately 40 percent of diagnosed breast cancers are found initially by women who feel a lump, according to the National Breast Cancer Foundation. One of the most important strategies a women can take when it comes to breast cancer detection is to perform monthly self-exams. Along with self-exams, screening tests remain vital to finding breast cancer when the chances of survival are at their highest. These tests include clinical breast exams, mammography and breast MRI for some women who are at higher risk or as a follow-up test after an abnormal finding. Earlier this year, Medicare approved coverage for tomosynthesis, also called 3D mammogram. This powerful tool enables doctors to obtain a more accurate view compared to digital mammography to better identify locations, sizes and shapes of abnormalities. “With 3D mammogram, we’re able to view breast tissue like pages of a book,” says Dr. Karen Kostroff, Chief of Breast Surgery at North Shore-LIJ Health System. “This is helping us to improve breast cancer detection rates and decrease patient call backs, which is extremely beneficial.”
- Improvements in Genetic Testing
- Approximately five to 10 percent of breast cancer cases are a result of a gene mutation inherited from a parent. Inherited mutations in two human genes, BRCA1 and BRCA2, account for approximately 20 to 25 percent of hereditary breast cancers, according to the National Cancer Institute. Harmful BRCA1 or BRCA2 genes can be inherited from either a person’s mother or father, and each child of a parent who carries the mutation has a 50 percent chance of inheriting the mutation. “Genetic testing is becoming increasingly common as we learn more about how heredity impacts breast cancer risk,” says Dr. Kostroff. “Currently, there are several screening tools and tests available to look for specific mutations in genes. It’s important for women to talk to their doctor to determine if genetic counseling or testing could be beneficial.”
- Surgical Options
- Between 60 and 75 percent of women who are diagnosed with breast cancer opt for a lumpectomy over a full mastectomy. It is less disfiguring and often has similar survival rates when combined with radiation. One of the primary risks of a lumpectomy has been needing a second surgery to remove more of the cancer or surrounding tissue. However, with advances in preoperative therapies and techniques used during surgery to determine the outer edges (margins) of cancerous tissue, the risk of requiring a second surgery has been greatly reduced.
- There are also new radiation recommendations for breast cancer treatment. The typical course of treatment used to be six to seven weeks, but new research has shown that three weeks of radiation offers the same level of benefits with fewer side effects.
- For many women who require chemotherapy as part of their breast cancer treatment, hair loss is one of the most difficult side effects. Researchers have discovered that cooling the scalp during chemo treatments can make it harder for cancer-fighting drugs to damage hair follicles. Using a tight-fitting cap that is cold enough to numb the scalp is helping to minimize hair loss in some cancer patients. Although there has not yet been FDA approval for cold caps, there are a number of products now on the market using this innovative technology.
- Nipple-sparing mastectomies are also becoming increasingly performed on women who have no sign of cancer in the skin or near the nipple. The advantage of this procedure is that the breast can look virtually unchanged and intact, which can improve self-esteem and self-body image. “Nipple-sparing mastectomy has helped patients that still need a mastectomy achieve the most incredibly natural result with one less operation to get to that endpoint,” according to Dr. Kostroff.
Thanks in large part to the many advances in diagnosing and treating breast cancer, survival rates for this complex disease that strikes one in eight women are improving. Through the combined proactive efforts of researchers, healthcare providers and women, we can all look forward to a future of fewer diagnosed cases, better outcomes and more long-term survivors. Do you want to learn more about breast cancer detection and treatment? Call the Katz Institute for Women’s Health Resource Center at 855-850-KIWH (5494) to speak with a women’s health specialist.