By Deborah Jeanne Sergeant
The first-degree relatives of women with breast and gynecologic cancers may be at higher risk for developing cancer. But the risk is not as significant as one may think.
“You have to put it all in perspective: 5% to 10% of all breast cancers are hereditary and 90% to 95% of the time, breast cancer is not an inherited cancer,” said physician Arnold Baskies, a past chairman of the board of the American Cancer Society and currently serving on the Global Breast Cancer Initiative of the World Health Organization in Geneva, Switzerland.
The question becomes what’s the risk and who’s at higher risk?
Some of the factors include the age of the patient. Baskies explained that the younger a patient is diagnosed, the higher the chances that the woman has an inherited type of cancer. That can indicate that her relatives may also carry the unfortunate genes and the higher risk associated with them.
Baskies also said that another red flag is whether there were other cancers in the family like prostate or pancreatic or ovarian cancer.
“Those are the types of things that will increase the risk of an inherited mutation indicating higher risk,” he said.
He recommended trying an online assessment tool and meeting with a genetic counselor.
At Elizabeth Wende Breast Care, Stamatia Destounis, physician and managing partner, said that deciding who should have genetic counseling is an individualized decision.
“We obviously will have them speak with a genetic counselor and discuss genetic testing for themselves and their family members,” Destounis said. “The situations are different depending on family history, age of the patient, how aggressive the tumor is and whether they’re of a minority population. Every patient is evaluated individually. We don’t do genetic testing on each patient. But if you have a young woman of 40 or 50 and there’s strong family history, then that patient has a conversation on genetic testing.”
Elizabeth Wende operates locations in Rochester, Batavia, Brighton, Geneseo, Greece, Victor, Watertown and Webster.
Kim Provenzano, nurse practitioner specializing in genetic oncology at Rochester Regional Health, said that if a woman carries one abnormal copy of a variant in the gene, she can pass that on to her children.
“Any woman diagnosed with breast cancer is generally counseled about risk for susceptibility,” Provenzano said.
She added that women diagnosed younger than 50 to 60 should have genetic testing, along with their siblings, children and parents. Genetic testing isn’t only for the patient’s female relatives.
“The risk of inheriting the genetic predisposition is the same for sons or daughters,” Provenzano said.
Male relatives of women with gene mutations related to cancer can have a greater risk for male breast cancer, pancreatic cancer and prostate cancer.
“You have to focus on family history features and tailor the screening to the family history,” Provenzano said. “They don’t need a referral. They can seek genetic counseling. Rochester Regional Health sponsors a no-cost community research screening to help improve the health of the community.”
Information is available at the Rochester Regional website, www.rochesterregional.org.
Whether at typical risk or not, women can reduce their risk of cancer through healthful lifestyle, including eliminating alcohol, eating a balanced diet, exercising and monitoring sun exposure and occupational and certain chemical exposures. Women should also follow the cancer screening protocols their healthcare provider recommends.