admin - October 11, 2013
If breast cancer runs in your family or you are in a high-risk ethnic group, you may be considering genetic testing. While experts generally recommend early diagnosis and testing, there’s more to genetic testing than simply receiving results. These considerations include the importance of heredity, understanding test results, and—believe it or not—the problem of knowing too much.
Heredity and Risk Factors
While family history is often a major factor when people decide if they should get genetic testing, the surprising fact is that heredity accounts for just 10% of breast cancers. In these cases, abnormalities in the BRCA1 or BRCA2 genes are to blame. When functioning properly, these genes regulate normal breast cell growth. Abnormal function caused by inheriting a mutated gene can cause ovarian cancer in women or breast cancer in men as well as women. The mere presence of a mutated gene, however, does not guarantee you will develop any form of cancer in your lifetime.
Genetic testing is recommended if:
- You have blood relatives on either side of your family who had breast cancer diagnosed before age 50.
- Both breast and ovarian cancer are present in your family, particularly in a one person.
- Other gland-related cancers run in your family such as thyroid, colon, and pancreatic cancers.
- A first-degree relative has had cancer in both breasts.
- You are of Ashkenazi (Eastern European) Jewish heritage, or Norwegian, Icelandic, or Dutch ancestry.
- A man in your family has had breast cancer.
Everyone agrees that early diagnosis is a good thing, but there may still be downsides to genetic testing. Before testing, you may want to discuss how a positive result will affect you with your doctor or a genetic counselor. Testing positive may cause anxiety, depression, or family tension for some patients, while others may be empowered to make better use of other tests like mammograms and MRIs or have fruitful discussions with family members who may also be at risk.
Angelina Jolie made headlines when she had a double mastectomy as a preventative measure after testing positive for a BRCA1 abnormality. Since her revelation, doctors have been beset by requests from women who would not benefit from the surgery at all. Women who test positive for faulty genes may choose less invasive risk-reducing solutions such as enhanced screening or chemopreventative drugs (tamoxifen and raloxifene).
Peace of mind is something many of us desire when it comes to our health. It helps set our minds at ease and allows us to stress and worry less. Genetic testing does have the power to provide peace of mind, but it may reveal the need for other preventive measures. This is similar to health screenings for other conditions like heart disease and stroke. However, genetic testing may not be right for everyone. Talk to your doctor to see if it’s right for you.