Are You at High Risk for Breast Cancer? 
Guidance and Procedures for Special Patients

If you have a family history of breast cancer on your mother or father’s side, you may be at increased for the disease—this does not mean that you will get cancer. It is a warning signal to alert you and your healthcare practitioners to be cautious. Often, women who are at increased risk are overwhelmed by fear; so they do not take the necessary steps to allow for the best protection.

We encourage you to follow the following components of a healthy lifestyle if you are at increased risk:

• Talk with your healthcare provider who understands your risk and concerns.
• Learn how to perform a breast self-exam from a qualified person. If you would like to be more involved in your breast health, learn more about our MammaCare Project, a proven approach for physical examination of the breast.
• Practice the Breast Health: Three-Step Plan for Preventive Care: self-breast exam, clinical examination, and mammography  
• Mammography screening guidelines for high-risk women vary. Most agree that if there is a family history of breast cancer, yearly mammography with a baseline at 35 years of age is important. If the family history includes a pre-menopausal breast cancer, mammography starting ten years earlier than when the relative’s breast cancer occurred is often a recommended guideline. Breast Cancer Detection and Mammography 
• Moderate exercise 3 to 4 times a week and maintaining a normal body weight significantly reduces the risk of breast cancer.

If your family member’s breast cancer was diagnosed after menopause in a first-degree relative (mother, sister, father) you are two to three times greater risk for having breast cancer. If the cancer occurred before menopause or if cancer was found in both breasts, the risk increases approximately five times. Breast cancer that occurs before menopause, or in both breasts, seems to have a higher incidence of being genetically inherited.

Inherited Breast Cancer Genes

In 1994 and 1995 two genes were identified that are directly related to breast and ovarian cancer. The genes, BRCA 1 and BRCA 2 are directly related to the potential to have breast or ovarian cancer.

About 7 percent of breast cancers and 10 percent of ovarian cancers are associated with an inheritance of one of these genes.. It is important you know what type of breast cancer your relative had and when it was diagnosed. It is also important to remember to ask for both sides of the family-your father and your mother.

If you have a family history of breast or ovarian cancer, talk to your healthcare professional about your potential to have inherited one of these genes.

Testing for inherited BRCA1 and BRCA2 genes may be indicated for:

• Individuals with a personal or family history of breast cancer before age 50 or ovarian cancer at any age
• Individuals with two or more primary diagnoses of breast and/or ovarian cancer
• Male breast cancer patients and their families

If you have a history suggestive of hereditary beast cancer, you may be referred to a genetic counselor. You will need to bring as much detailed information about family members’ diagnoses as possible. The counselor will help you understand whether genetic testing is likely to be useful and how this might change your future care. You may want to have other family members attend the counseling session with you.