The other approach is assessment of risk based on epidemiologic studies. Hereditary breast cancer typically presents in a younger age group. The classic signs of hereditory breast cancer include a history of cancer in two or more relatives, typically through two or more generations, an increased incidence of bilateral cancers, multiple primary tumors and an autosomal dominant pattern of inheritance. In hereditary breast cancer, screening high-risk families can play a significant role in reducing the mortality from cancer. This is achieved by a realistic assessment of an individual's hereditary risk and by empowering them in their pursuit of health-promoting activities and a participation in cancer screening guidelines.
Patient education is an important component of any cancer assessment program.
It is important to realize that most individuals with a family history of breast cancer will not have an increased hereditary risk of this disease. Many will, however, benefit from risk analysis and a better understanding of their risk, compliance with screening guidelines, and what genetic susceptibility testing can offer. Currently, testing for increased hereditary risk of breast cancer is commercially available for mutation in the genes BRCA1 and BRCA2. Aside from breast, families with BRCA1 mutation have increased risk of development of cancer of the ovary, colon, and prostate. In addition, not all of these mutations can be detected and an increase in hereditary risk can be due to mutation in genes not yet identified.