What to Do if Someone in Your Family Has Had Breast Cancer

Monday, July 6, 2009

If someone in your family has or had breast cancer, you are at higher risk of getting the disease yourself.

"I draw out a family tree for three generations," says M. William Audeh, MD, a medical oncologist who works in cancer risk assessment at Cedars-Sinai Medical Center in Los Angeles. And that means both branches: "Many women assume they should only be concerned about their mother's side of the family, but breast cancer risk can be inherited from either parent," says Dr. Audeh.

The breast cancer gene
Whatever you learn from your own family tree, you may decide to be tested for the BRCA-1 or BRCA-2 gene mutations. Far from every woman who gets breast cancer carries BRCA gene mutations, but those who do have one of the mutations (they’re more common to women of Ashkenazi Jewish descent, for instance, and a recent study suggested that U.S. Hispanic women are also at higher than normal risk) are three to seven times more likely to get the disease than women without alterations in those genes.

2 Women Consider Prophylactic Mastectomy
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* Should I Get the BRCA Gene Test?
* What Causes Breast Cancer?

Women with a family history of breast cancer will still need to be extra vigilant.

What You Need to Know About Breast Self-Exams

You know the drill: The breast self-exam (BSE) illustrations on those pamphlets usually show a woman with one arm up over her head, pushing the fingers of her other hand across her breast—in search of a lump or some other sort of change. Your ob-gyn may have talked to you about doing this every month at home, ideally at a time when your breasts don't feel tender or swollen.

BSE controversy
The truth is, even doing regular BSEs (without regular mammograms) may not protect you. A large study conducted in China by researchers from the Fred Hutchinson Cancer Research Center in Seattle made headlines in 2002 by suggesting that women who were taught to do regular BSEs didn't fare any better—or live any longer—than women who were not taught to do them. On average, they didn't find cancer any earlier. Still, many medical experts believe women should familiarize themselves with how their breasts feel.

Have you ever found a lump in a breast self-exam?

Dense breasts
BSEs can be tricky for women with dense breast tissue—which is common for younger women. "Mostly they don't know what they're feeling or are not confident," says Janet Wolter, MD, a medical oncologist and the Brian Piccolo Chair of Breast Cancer Research at Rush University Medical Center in Chicago. "The breast is constructed like an orange or a grapefruit; you'll feel segments, and that's scary, but it's normal."

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More about breast cancer screening

* 3 Ways to Spot Breast Cancer
* How to Do a Breast Self-Exam

BSEs as you age
For premenopausal women, "the easiest day to remember to do a BSE is the first day of your cycle, when you get your period," suggests Julia A. Smith, MD, director of the NYU Cancer Institute's breast cancer screening and prevention program and director of the Lynne Cohen breast cancer preventive care program at NYU in New York City. If you feel something, wait two weeks and then do another BSE. The odds are it'll be gone—breast tissue often changes throughout the menstrual cycle, says Dr. Smith. But if the abnormality persists, you should see your doctor.

Older women generally have easier BSEs, because after menopause the tissue gets much softer: "If you put a Ping-Pong ball in there, you'd feel it right away," as Dr. Wolter puts it.