If breast cancer runs in your family, you may have questions about what that means for your own health. Should you start mammograms earlier? Could genetic testing help you understand your risk?
Your family health history can provide important information, but it is only one part of your overall breast cancer risk. Your age, personal medical history, reproductive history, breast density, genetics and other factors can also play a role.
The good news is that you do not have to figure out your risk on your own. Your primary care provider can help you understand your family history, identify factors that may increase your risk, determine which preventive screenings are appropriate and connect you with specialists or genetic counseling when needed.
What Does Family History Have to Do With Breast Cancer Risk?
Having a family history of breast cancer can increase your risk, particularly when the cancer occurred in a close relative, occurred at a younger age or affected multiple family members.
A first-degree relative is a parent, sibling or child. Having breast cancer in a first-degree relative can increase your risk, and having multiple close relatives with breast cancer can increase it further. The age at which a relative was diagnosed can also be important when assessing your family history.
Family history can also include more than breast cancer. Certain patterns of breast, ovarian, pancreatic and prostate cancers in a family may provide clues about inherited cancer risk.
However, having a family history does not mean you will develop breast cancer. Likewise, many people who develop breast cancer do not have a known family history of the disease. Your primary care provider can help put your family history into context with your other risk factors.
What Should You Know About Your Family’s Cancer History?
The more information you have, the more useful your family history can be.
If possible, find out:
- Which relatives have had cancer
- What type of cancer they had
- How old they were when they were diagnosed
- Whether they had cancer in one or both breasts
- Whether more than one relative had breast cancer
- Whether relatives had ovarian, pancreatic or certain prostate cancers
- Whether anyone in your family has had genetic testing
- Whether a family member has been found to have a BRCA1, BRCA2 or other inherited genetic change
It is also important to consider both sides of your family. Cancer risk can be inherited through your mother’s or father’s side of the family.
You do not need to have a complete family tree before talking with your provider. Even information that is incomplete can help your healthcare team determine whether additional risk assessment or screening may be appropriate.
When Does Family History Suggest a Higher Risk?
Certain family history patterns may warrant a closer look. These can include:
- A parent, sibling or child with breast cancer
- Several relatives with breast cancer
- Breast cancer diagnosed at a younger age
- A male relative with breast cancer
- A relative with ovarian cancer
- A relative who has had both breast and ovarian cancer
- A known BRCA1, BRCA2 or other inherited cancer-related gene change in the family
- A combination of breast cancer and other cancers associated with hereditary cancer syndromes
These patterns do not automatically mean that you have an inherited genetic risk. Instead, they are reasons to talk with your healthcare provider about whether additional risk assessment or genetic counseling may be appropriate.
How Your Primary Care Provider Can Help Assess Your Risk
Understanding your family history is an important part of primary care.
During a preventive visit, your provider can review your personal and family health history and look at the bigger picture. They may consider:
- Your age
- Your family history of breast and other cancers
- Your personal history of breast conditions or previous biopsies
- Your reproductive and hormonal history
- Your breast density, when known
- Previous mammogram results
- Known genetic risk factors
- Other personal factors that may affect your breast cancer risk
Your provider can then help determine what screening schedule is appropriate for you and whether you may benefit from additional evaluation.
This is one reason routine primary care visits are about more than treating an illness when you are sick. Preventive care gives you an opportunity to review your health history, identify potential risks and make a plan for staying ahead of them.
Could You Benefit From Genetic Counseling?
Genetic counseling may be recommended when your personal or family history suggests that an inherited genetic change could be contributing to your cancer risk.
A genetic counselor can take a detailed look at your family’s cancer history and help determine whether genetic testing may be appropriate. They can also explain what genetic testing can—and cannot—tell you, what different results could mean and how those results may affect your healthcare decisions.
Genetic counseling does not necessarily mean that you need genetic testing. The goal is to help you understand your options and make an informed decision based on your individual circumstances.
If your primary care provider believes genetic counseling could be helpful, they can help connect you with the appropriate specialist or service.
What Are BRCA1 and BRCA2?
You may have heard of the BRCA1 and BRCA2 genes when talking about breast cancer.
These genes normally help protect cells from developing cancer. Certain inherited changes in these genes can increase the risk of breast and ovarian cancers, among others. Other genes, including PALB2, CHEK2 and ATM, can also be associated with increased breast cancer risk.
Having a genetic change does not mean that someone will definitely develop breast cancer. Instead, it can indicate that their risk is higher than average and may affect recommendations for screening and risk management.
If a genetic change has been identified in your family, tell your primary care provider. That information can be an important part of determining what additional care or referrals may be appropriate.
Does Family History Change Your Mammogram Schedule?
It can.
People with a higher-than-average risk may need a different approach to breast cancer screening than someone at average risk. Depending on your individual risk factors, your provider may recommend starting screening earlier, screening more frequently or discussing additional imaging.
For some people at particularly high risk, screening may include both mammography and breast MRI. The appropriate approach depends on your individual risk and should be determined with your healthcare team.
This is why there is no single breast cancer screening schedule that is right for everyone.
If you have a family history of breast cancer, your primary care provider can help determine whether your screening plan should be different from routine recommendations.
What If You Don’t Have a Family History of Breast Cancer?
No known family history does not mean you have no risk.
Breast cancer risk is influenced by many factors, including age, genetics, reproductive history, breast density and personal medical history. Some people who develop breast cancer have no known family history or inherited genetic change.
That is why routine preventive care and recommended breast cancer screening remain important, even if no one in your family has had breast cancer.
Your primary care provider can help you understand your individual risk and keep preventive screenings on track.
What Should You Bring to Your Next Primary Care Visit?
If you know that breast cancer runs in your family—or you are simply unsure about your family’s history—consider gathering as much information as you can before your next appointment.
You can start by asking relatives:
- Who in our family has had breast cancer?
- What age were they when they were diagnosed?
- Has anyone had ovarian, pancreatic or certain prostate cancers?
- Has anyone had genetic testing?
- Has anyone been told they carry a BRCA1, BRCA2 or another cancer-related gene change?
Bring what you learn to your primary care provider, even if you do not have all the answers.
Your provider can help you understand what the information means, determine whether additional risk assessment is appropriate and discuss your next steps.
Your Family History Is Information You Can Act On
You cannot change your genes or your family history, but knowing your history gives you an opportunity to make informed decisions about your health.
Your primary care provider can be an important starting point—helping you understand your individual breast cancer risk, stay up to date with recommended screenings, identify when additional evaluation may be appropriate and connect you with genetic counselors or other specialists when needed.
If breast cancer runs in your family, you do not have to navigate what it means for you alone. Bring your questions and your family history to your next primary care appointment, and work with your healthcare team to create a screening and prevention plan that fits your individual needs.
Ready to talk about your breast cancer risk?
Schedule a preventive visit with an Avance Care primary care provider to review your family history, preventive screenings and questions about your individual health.
