The role of genetics in breast cancer

Q: If breast cancer runs in my family, what preventative measures should I take to help reduce my risk?

I often remind my patients that most breast cancer is due to bad luck, not bad family. With breast cancer striking one out of every nine women, many families have a close relative with breast cancer, without any genetic tendency. That said, it is still important to determine how significant the risk is in your family. Individuals with several first degree relatives (sister, mother) with breast cancer; relatives affected by breast cancer at a young age (less than 50); or “triple negative” breast cancer which doesn’t express estrogen, progesterone or HER-2-neu receptors, are more likely to carry a breast cancer genetic abnormality. There are likely other genetic tendencies not associated with one of the known breast cancer genes, but the family tendencies described above are probably good indicators of increased risk.

Another important aspect to understand is that “increased risk” does not mean an individual will develop breast cancer – it just means his or her risk is higher than that of the general population. For example, a patient with a 50% higher risk is not looking at 50/50 odds of developing breast cancer. The average risk of developing breast cancer is 11% (1 in 9); that means the patient has a 5.5% higher risk than the average person, for a risk of 16.5%. Remember, this also means the patient has an 83.5% chance of not developing breast cancer.

There are many preventive measures that can be taken to reduce one’s risk of breast cancer. Often times these are healthy lifestyle changes we should all be making regardless of any increased risks. Controlling calories and weight, watching the amount of fat in the diet, and getting regular exercise have consistently been shown to be associated with a lower rate of breast cancer. Interestingly enough, these are the same recommendations you may receive from a cardiologist to lower risk of cardiovascular disease, or an endocrinologist to lower risk of diabetes.

Steven Standiford, M.D., FACS, brings 25 years of oncology experience to his positions as surgical oncologist, Chief of Surgery and Chief of Staff at Cancer Treatment Centers of America® in Philadelphia. His special expertise includes surgical oncology, breast cancer and complex pelvic malignancies. He is also a member of the medical advisory board for The Dr. Oz Show. Dr. Standiford was recognized as one of Castle Connolly’s Top Doctors® in 2013 and 2014.

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