Familial Cancer Service

What is the Familial Cancer Service?

A family history of breast cancer means having a relative who has had the disease. The importance varies from not increasing your risk at all, to increasing it significantly.

Only a small number of women fall into a high risk category. These women may have inherited a gene mutation, or change, which makes them more likely to develop breast and ovarian cancer than other women.
 

How is the risk of developing cancer assessed?

Your family history will be recorded in detail, including any cancer in a first or second degree male or female relative.

First degree relatives are parents, siblings and children.

Second degree relatives are aunts, uncles, nieces, nephews and grandparents on both sides of the family.
 

What factors may indicate that the risks are very high?

You may be at potentially high risk if you have had:
  1. Three or more relatives on the same side of the family with breast or ovarian cancer.
  2. Two or more relatives on the same side of the family with breast or ovarian cancer, including any of the following features:
    •  A relative with breast cancer who is 45 years or younger, plus another relative on the same side of the family with sarcoma at 45 years or younger.
    •  Family members already known to carry a gene mutation which predisposes them to a high risk of breast or ovarian cancer.

How do genes increase the risk of breast cancer?

A mutation (change) occurs in some genes, and this leads to a possible increased risk. Several genes associated with an increased risk of breast cancer have been identified in the past few years – in particular, the BRCA1 and BRCA2 genes. Several other genes are associated with a moderately increased risk but research is still proceeding on these and testing is not currently available.

Once the changed gene is present, it may be passed from mother or father to any of their children. There is a 50% chance of inheriting this changed gene from one of your parents.
 
If it is present, there is a 60-80% lifetime risk of developing breast cancer, and a 20-40% lifetime risk of developing ovarian cancer.

Only 5% of all breast cancers are due to this type of inherited genetic mutation.

Who can have a gene test?

Women in the potentially high risk group may wish to discuss gene testing for the BRCA gene mutations.​ The test involves taking a blood sample.

Usually a relative who has had breast or ovarian cancer is tested first.

It is vital that you understand the implications before arranging to take the test.
 
At the Familial Cancer Service, we perform a breast examination, mammogram and ultrasound, to exclude any existing breast problem.
 
Following discussion, if you fall into the high risk group and wish to proceed with the test, you can be referred to a Clinical Geneticist.

What happens next?

For women with an increased risk who do not have the genetic test performed or in whom a mutation is not found, the frequency of screening for breast cancer will be discussed and a recommendation made on the basis of the individual’s family history. This may involve mammography, ultrasound and in some cases magnetic resonance imaging (MRI) of the breasts.  
 
If a breast cancer gene mutation is found surveillance methods as above will be discussed. You may also be referred to a Breast Surgeon and Gynaecologist to discuss risk reducing surgical procedures.

 


 

 

Additional Information - The Wesley Breast Clinic

  • Breast core biopsy

  • Breast implants

  • Common Breast Problems