This article will review the importance of getting an accurate family history, and how that can affect someone’s risk of getting breast cancer. The role of genetic testing will also be discussed.

Family History and Breast Cancer Risk

Breast cancer is the most common cancer among women, affecting about 13% of women throughout their lifetimes. A family history of the disease does increase your risk, but by how much depends on who in your family had breast cancer.

Here’s a general sense of how family history affects a woman’s risk of breast cancer:

Collecting Your Family History

Your mother is an important figure in your cancer risk profile if she has or has had breast cancer. But, given the above, it’s also helpful to find out if cancer has affected other family members, including grandparents, aunts, uncles, and cousins. Don’t assume that you know this information—it’s worth specifically asking.

For the purpose of building your own family history, you need to know:

What type of cancer a relative had What age they were diagnosed If they were cured, still living with cancer, or have died

If your mother or father are alive and able to share your family’s background with you, filling out the Cancer Family History Questionnaire that was created by the American Society of Clinical Oncology can help you keep track of the information. Once you gather your family history, it would be useful to keep that record for yourself and for other family members who share some of your family medical history.

Conversations About Cancer

It’s also important to consider connecting with your family members by asking about more than just the facts about their illness.

How did they deal with the fear and uncertainty?Who did they lean on for support?How did they celebrate being healthy?

Let them talk about the obstacles they overcame and the things they learned about life as they fought their illness. While these conversations won’t add facts about your health, they can be valuable discussions.

Using Your Family History

You should certainly share your family history with your medical team. Your healthcare providers might advise genetic testing or counseling if your family history suggests that you could be carrying a breast cancer gene.

Some red flags include:

Personal history of cancer of any kind before the age of 50 More than one relative with the same type of cancer One family member who has more than one type of cancer A family member who has cancer not typical for their gender, such as breast cancer in a male Certain combinations of cancer, such as the combination of breast cancer with ovarian cancer, uterine cancer, colon cancer, prostate cancer, pancreatic cancer, or melanoma Cancer in both of a pair of organs, for example, both breasts or ovaries

When You Can’t Find Your Family History

While many women already know if their mother, sister, or daughter have had breast cancer, you might not have this information.

If your close family members passed away at a young age, if some of them didn’t have access to health care (and might not have been diagnosed), if you were adopted, or if members of your family have been otherwise separated, you might not know which illnesses run in your family.

While family history is important information, breast cancer screenings (such as mammograms) are the most important tools for early detection, whether or not you have a family history of the disease.

Genetic Testing

With new genetic testing techniques, breast cancer genes can be identified even before the disease develops. However, such testing isn’t the only factor influencing your risk.

There are a number of genes associated with breast cancer. The most common of these are BRCA1 and BRCA2 mutations, but there are over 70 identified gene mutations associated with breast cancer. And there is a link between breast cancer genes and the outcome of the disease.

While your family history is a record of the diseases that your family members were diagnosed with, genetic testing is a bit different.

With this in mind, genetic testing requires a complex decision-making process. The genes you should be tested for and the overall value of the test depend on a number of factors, including your age, health history, family history, race, and ethnic background.

A Word of Caution Regarding Home Genetic Tests for Breast Cancer

The idea of a home genetic test for breast cancer is exciting to many people, as these tests might help them avoid the clinic while being their own advocate in their health. It’s important to understand the limitations of these tests, if you choose to do one.

For example, a popular at-home genetic test identifies three breast cancer genes that are more common among Ashkenazi women but are rare in other ethnic populations. While the company is transparent in admitting that the test only checks for three out of a potential 1000 BRCA mutations, not everyone reads the small print.

The bottom line on this test is that for Ashkenazi Jewish women, a positive test might let them know they should see their healthcare provider, but a negative result is meaningless. For most women, the test isn’t helpful, and can actually be harmful if they trusted the results and did not have formal testing.

Genetic Testing

Genomic testing and whole exome sequencing are genetic tests that can provide you with information about all of your genes, not just breast cancer genes. This type of testing can be useful, but the cost might not be covered by your health insurer.

Furthermore, “good” results can provide a false sense of security. You can develop breast cancer even if you don’t have a known breast cancer gene.

Genetic Counseling

Ideally, everyone would have genetic counseling when testing. A genetic counselor may find areas of concern, and can talk to you about what testing means.

For example, not all gene mutations that raise the risk of breast cancer do so to the same degree. This concept is known as penetrance.

One particular mutation may raise the risk such that 70% of women with the mutation develop breast cancer in their lifetime, whereas other mutations may raise the risk perhaps 50%, giving a woman a lifetime risk of developing the disease of 1 in 6 rather than 1 in 8.

Summary

Getting an accurate family history can be an important tool in helping to determine your individual risk of developing breast cancer. With the average risk of a woman getting breast cancer being about 13%, knowing if you have any increased risk can be important for your healthcare team.

Genetic testing looking for breast cancer genes can be beneficial to some women, especially if they have a strong family history of breast cancer at a young age or any family history of male breast cancer. Talk to your healthcare provider to see if genetic testing is suggested for you.

A Word From Verywell

Whether you have a family history of breast cancer or not, there are ways for you to lower your own risk. Make sure that your healthcare team knows if your mother, sister, daughter, or other family members had this disease or if you or any of your relatives carry a gene for the disease. And definitely don’t skip your annual screenings.

More and more women and men are getting diagnosed with breast cancer at an earlier stage, receiving more effective treatment, and surviving for years after the diagnosis. While you should be vigilant if you have a family history of breast cancer, there is no need to live in fear.

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