FAMILY HISTORY/ GENETIC TESTING
Some women have a strong family history of breast and/or ovarian cancer. This may include close relatives developing breast cancer at a younger age, usually under 50, breast cancer affecting both breasts, ovarian cancer, or several family members with these cancers. In some families, this may be due to an inherited gene change, such as BRCA1 or BRCA2, which can significantly increase the lifetime risk of breast and ovarian cancer.
Women with a strong family history should consider seeing a breast specialist for advice about their level of risk, appropriate screening and possible preventative options. If genetic testing is appropriate, referral can be made to a specialist genetic service.
Genetic testing is usually offered first to the family member who has had breast or ovarian cancer. If a gene change is found, testing can then be offered to other family members. If no gene change is detected, this does not always remove the need for ongoing breast awareness and regular screening, as recommendations will depend on the overall family history.
Women with a strong family history of breast cancer may need earlier and more frequent breast screening. This often involves annual mammography, usually starting about 5–10 years before the age at which the youngest affected family member was diagnosed. In some higher-risk situations, such as a very strong family history or a confirmed BRCA gene change, annual breast MRI may also be considered.
Women with a confirmed pathogenic gene mutation should also discuss risk-reducing options with a breast specialist. These may include the use of medication such as Tamoxifen, as well as Preventative surgery such as Risk-reducing Mastectomy with Immediate Reconstruction, or removal of the ovaries and fallopian tubes to reduce ovarian cancer risk.