Family History – Breast Cancer Risk factor in female- Facts you need to know

Fact: It’s important to keep in mind, though, that majority of breast cancer cases involve women who don’t have a strong family history of the condition. 

These are random cancers and not linked to inherited genetic mutations. Regular breast cancer screenings, like mammograms, clinical breast exams, and self-examinations, are essential for all women, regardless of family history. 

A small percentage of woman’s risk of breast cancer might be influenced by her family history. 

According to research, women who have a first-degree relative (mother, sister, or daughter) who has had breast cancer are at a higher risk than women who don’t. If several first-degree relatives have been affected, the risk is even higher. It is said about 15% of Breast Cancer runs in the family, this data is extrapolated from Western population. For India the number reported varies from < 5% to > 24%. 

This hereditary variety of Breast cancer is majorly due to certain genes like BRCA 1 and BRCA 2 which cause mainly Breast and Ovarian cancers run in the family. It means that if a woman harbour’s BRCA gene there is 80% chance that she will get Breast cancer in her lifetime and 40 % chance that she will get Ovarian cancer. 

There is a 50 % probability that the gene will be transferred to the next generation and can cause cancer. The exact prevalence of these genes in the Indian population is not yet known. BRCA 1 & BRCA 2 constitute 80% of hereditary breast cancer, there are other genes such as CHEK, PALB, ATM, etc which also increase the risk of breast cancer.

It’s important to acknowledge that not all family histories are created equal.  If a woman feels apprehensive about cancer being present in family, first of all she needs to meet a genetic counsellor to ascertain the exact risk and only after the assessment the genomic analysis is recommended. It’s a simple test which can be done both on saliva or blood. If the presence of genomic aberrations are found especially BRCA 1 / 2, the woman is put on high risk screening protocol and is recommended prophylactic / risk reducing surgeries in due course.

Risk Reducing mastectomy is generally done in early 40s when the woman’s pregnancy and lactation is over. The procedure involves removal of breast fat and ducts preserving the nipple and skin. The defect is filled either by an implant or a flap. 

The risk reducing oophorectomy is generally done in late 40s when woman’s menopause is due and ovarian function diminishes. Risk Reducing Mastectomy reduces the risk of death due cancer by 90% and Risk Reducing oophorectomy reduces the risk of death due to cancer by 97%. 

Those women who do not test positive for genomic aberrations are recommended high risk screening due to increased familial risk but more radical procedures like risk reducing surgeries are not recommended. For people with a longstanding family history of breast cancer, genetic testing, and counselling may be suggested to determine their personal risk and to guide early identification and prevention measures.

Thus, while family history does increase the risk of breast cancer, it is not a guarantee that a woman will develop the disease. Early detection, lifestyle choices, and healthcare guidance can play a crucial role in reducing the impact of family history on an individual’s breast cancer risk.

Leave a Reply