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

If someone in your family has or had breast cancer, you are at higher risk of getting the disease yourself. The first step in learning about your risk is to take a look at how close those relatives are and how they fit into your family tree—on your own or with a genetic counselor or medical oncologist.

"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.

Deciding whether to get tested for the BRCA gene mutations is just the first excruciating choice for those tracing a family connection. What will you do with your test results? Some women who test positive commit to more frequent check-ups and mammograms (perhaps two times a year); others opt to take one of two estrogen-blocking drugs (tamoxifen or raloxifene); still others decide to have their breasts and/or their ovaries removed as a prophylactic—or preventive—measure.

Even testing negative for the BRCA mutations may not provide the kind of closure you were looking for. Women with a family history of breast cancer will still need to be extra vigilant.