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| Genetic Testing for Breast Cancer Risk |
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|  | Page Options  Print This Document  E-Mail This Document  Order Free CopyQuick LinksDictionaryFunding OpportunitiesNCI PublicationsNCI CalendarEspañolNCI HighlightsOctober is Breast Cancer Awareness MonthNCI Annual Progress Report on Cancer Research 2003Women, Tobacco and Cancer: Agenda for 21st CenturyPast Highlights | Background on Breast Cancer
How Genes Affect RiskWho is at increased risk for breast and ovarian cancer?What is a gene?How might genes affect breast cancer risk?
Altered Breast Cancer GenesDoes every woman with an altered breast cancer gene get cancer?Do men with an altered BRCA1 or BRCA2 gene have an increased cancer risk?
Genetic Testing: Points to ConsiderWhat is genetic testing for cancer risk?What are the limitations of the test?What can I do if I have an altered gene?
Should I Be Tested?What are the advantages and disadvantages of testing?What is informed consent?Questions you may want to ask your doctor or other health professional
Who Can I Call?
Background on Breast Cancer

For American women, breast cancer is the second most common form             of cancer and the second leading cause of cancer deaths. Each year,             more than 180,000 women in the United States learn that they have             breast cancer.            
Some kinds of cancer, such as breast cancer, seem to run in             families. There is a test that may tell some people if they are at             risk for this kind of breast cancer. Before getting tested, however,             there are many factors to consider.            
For more information about cancer and genetic             testing, you should talk to a doctor or other health care             professionals trained in genetics or call the National Cancer             Institute's Cancer Information Service at 1-800-4-CANCER.

Back to TopHow Genes Affect Risk

Who is at increased risk for breast and ovarian cancer?

A woman with a significant family history of breast and/or ovarian cancer has an 	increased risk of getting these cancers. You have a significant family history 	if:	- 		you have two or more close family members who have had breast and/or ovarian 		cancer and		 			the breast cancer in the family members has been found before the age of 50.		   A close family member can be your:	- 		mother		 		sister				grandparent (on either your mother's or father's side)		
- 		mother's sister		 			father's sister		   A close family member can also be your father, brother, or uncle, but breast cancer is very rare in men. Your family history of cancer can be assessed by a doctor or other health care professional trained in genetics who will determine if you have a significant family history of breast and/or ovarian cancer. Having this information may help you learn about your cancer risk and help you decide if genetic testing is right for you.
It is important to know that a family history of cancer does not mean you are going to get cancer. Many things such as family history and age may increase a person's chance (or risk) of getting cancer, but family history alone is not the only reason people get cancer. Scientists do not know all the reasons why people get cancer.

What is a gene?

Genes are nature's blueprints for every living thing. Genes come in pairs: one 	set of genes is passed down (or inherited) from your mother and the other set 	from your father. Genes determine how your body will function and grow, as well 	as the color of your hair and eyes.		
How might genes affect breast cancer risk?

Some genes do not function properly because there is a mistake in them. If a gene has a mistake, it is said to be mutated or altered. In fact, all people have altered forms of some genes. Some alterations can increase your risk for certain illnesses such as cancer. In recent years, gene alterations have been found in some families with a history of breast cancer. Some women in these families also have had ovarian cancer.
These alterations are most often found in genes named BRCA1 and BRCA2 *(**BR**east		**CA**ncer Gene **1** and **BR**east **CA**ncer Gene **2**)*. 	Both men and women have BRCA1 and BRCA2 genes, so alterations in these genes 	can be passed down from either the mother or the father. It is likely that more 	genes like these will be discovered in the future.
Back to TopAltered Breast Cancer Genes

Does every woman with an altered breast cancer gene get cancer?

A woman with a BRCA1 or BRCA2 alteration is more likely to develop breast or ovarian cancer than is a woman without an alteration. However, not every woman who has an altered BRCA1 or BRCA2 gene will get breast or ovarian cancer, because genes are not the only factor that affect cancer risk. Therefore, an altered gene is not sufficient to cause cancer.
Most cases of breast cancer do not involve an altered BRCA1 or BRCA2 gene. At 	most, 1 in 10 breast cancer cases involves an inherited altered gene, and not 	all inherited breast cancer involves BRCA1 or BRCA2.		
Do men with an altered BRCA1 or BRCA2 gene have an increased 		cancer risk?

Although breast cancer is rare even in men with an altered gene, men with an 	altered BRCA2 gene have higher rates of breast cancer than men without an 	altered gene. Men with an altered BRCA1 or BRCA2 gene may also have a slightly 	increased risk of prostate cancer. Even if a man never develops cancer, he can 	pass the altered gene to his sons and daughters.
Back to TopGenetic Testing: Points to Consider

What is genetic testing for cancer risk?

Genetic testing is a process in which it is possible to look for genetic alterations that may be associated with an increased risk of particular cancers. Genetic testing may reveal whether the cancer risk in a family is passed through their genes.
Although the lab test itself is quite complex, only a blood sample is needed. Genetic testing for breast and ovarian cancer risk involves looking for altered genes such as BRCA1 and BRCA2.
Because finding an altered gene can take several weeks or months, test results may not be readily available. The price of testing also varies. The price can be quite high and may not be covered by health insurance, or you may not want your insurance company to know you were tested. Ask your doctor or other health professionals for more information on genetic testing and health insurance coverage.
What should I think about before getting tested?-   limitations 		of the test		 		coping with cancer risk				advantages of testing		
- 			disadvantages of testing		
What are the limitations of the test?
Testing for breast cancer risk will not give you a simple "yes" or "no" answer. Finding a gene alteration in BRCA1 or BRCA2 indicates an increased risk of getting cancer, but it will not indicate if or when cancer will develop.
Currently, altered genes cannot be "fixed," but some day research may make it 	possible to prevent the disease in people who carry an altered gene.	
What can I do if I have an altered gene?

If you are at increased risk for breast or ovarian cancer, you can make choices 	that may help reduce your risk of getting cancer or help find cancer early. Of 	course, you can take these steps with or without getting tested for a BRCA1 or 	BRCA2 alteration. 
**Increased surveillance:**		You may choose to be monitored more closely for any sign of cancer. This may 		include more frequent mammograms, breast exams by your doctor, breast 		self-exams, and an ultrasound exam of the ovaries.		
**Prophylactic surgery:**		You may choose to have your healthy breasts and/or ovaries removed. This 		surgery may reduce the risk of cancer, but doctors do not know by how much. 		Becausethe surgery cannot remove all of the breast or ovarian tissue, some 		women who have chosen this surgery have later developed breast or ovarian 		cancer in the tissue that was left behind.		
**Join a research study:**		Because it is not yet possible to prevent cancer, you may choose to join a 		research study that is looking at ways to reduce cancer risk. This may entail 		changing your diet, reducing the amount of alcohol you drink, or trying new 		drugs to reduce the risk of cancer.
What we know now about cancer is due in large part to research. By taking part 	in a study, you could help researchers find better ways of preventing and 	treating cancer.
Back to TopShould I Be Tested?

What are the advantages and disadvantages of testing?

Genetic testing may help you to:	- 		Make medical and lifestyle choices.		 		Find out you do not have an altered gene.				Cope with your cancer risk.		
- 		Decide whether or not to have prophylactic surgery.		 		Give other family members useful information (if you choose to share your test 		results).					Contribute to research.		

There are also disadvantages to testing:	- 		There is no proven way to reduce cancer risk.		 		There is no guarantee that test results will remain private.				You may face discrimination for health insurance, life insurance, or 		employment.		
- 		You may find it harder to cope with your cancer risk when you know your test 		results.		 			Negative test results may provide a false sense of security because you think 			you have no chance of getting cancer, which is not true. You would still have 			the same risk as women in the general population.		   Lastly, genetic testing can affect relationships with family members. You should think about who in your family might want to know your test results, and whom you might want to tell.
If you are thinking about being tested, you should decide what the advantages 	and disadvantages of testing are *for you*. What is right for one person 	is not always right for another.		
What is informed consent?

If you are thinking about genetic testing, you should be informed, verbally and *in 		writing,*about the risks of getting tested as well as what the test can and cannot tell you. You should also sign a form to show that you have been given this information and want to be tested.
After reading the consent form, you can decide if testing *is* or *is not*	right for you. You may also choose to delay the decision, if perhaps this is 	not the best time for you to be tested.
Questions you may want to ask your doctor or other health 		professional

If you are thinking about genetic testing, be sure to talk with your doctor, 	genetic counselor, or other health professionals and take some time to answer 	these questions. You may want to get more than one opinion.	- 		What are the chances that a gene alteration is involved in the cancer in my 		family?		 		What are my chances of having an altered gene?				Besides altered BRCA1 or BRCA2 genes, what are other risk factors for breast 		and ovarian cancer?		
- 		Are all genetic tests the same? How much does the test cost? How long will it 		take to get my results?		 		What are the possible results of the test?				What would a positive result mean for me?		
- 		What would a negative result mean for me?		 		How might a positive test result affect my health insurance? life insurance? 		employment?				Do I want to submit my test results to an insurance company? If yes, will they 		pay for the testing?		
- 		Where will my test results be placed/recorded? How might this affect me? Who 		will have access to them?		 		Will having the test do anything to make me change my current health practices?				What are my reasons for wanting to be tested?		
- 			What type of cancer screening would be recommended if I don't get tested?		
Other questions to think about and discuss with your family:	- 		What effect will the test results have on me and on my relationships with my 		family members if I have an altered gene? If I don't have an altered gene?		 		Should I share my test results with my partner? parents? children? friends? 		others? How will they react to the news, which also affects them?					Are my children ready to learn new information that may one day affect their 			own health?

Back to TopWho Can I Call?

A person who is considering genetic testing should       speak with a professional trained in genetics before deciding whether to       be tested. For more information on genetic testing or for a referral to       centers that have health care professionals trained in genetics, search the PDQ® Cancer Genetics Services Directory or call the       **Cancer Information Service (CIS)**. 

The CIS provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment. 

Toll-free: 1-800-4-CANCER (1-800-422-6237) 

TTY: 1-800-332-8615

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