Weekly Tip
Genetics and Breast Cancer
Last month a leading Australian health insurer found itself under attack for promoting genetic testing for members. The criticism was based on accuracy, ramifications of results on premiums and whether or not the money would have been more effective spent on risk identification and prevention / management (something that lifestylemedicine.net.au is certainly a fan of).
However, regardless of the debate last month, genetic screening for the likelihood of developing breast cancer is certainly beneficial depending on your family history (another criticism from last month was blanket screening). 1 in 9 women will be diagnosed with breast cancer before the age of 85. It's not only women though with 1 in 747 men also being diagnosed with breast cancer. Each year, 2707 women and 19 men die of breast cancer
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Lifestyle ProgramsWhat causes it?
An increasing age, family history, inheritance of mutations in the genes BRCA2, BRCA1 and CHEK2, exposure to female hormones (natural and administered), obesity (diet and exercise) and excess alcohol consumption, are all associated with breast cancer, as well as some benign breast disease and past exposure to radiation. To learn more about cancer in general read The story of Cancer in the medical conditions section.
Your genetic risk
There are two genes known as BRCA1 (BReast CAncer gene one) and BRCA2 (BReast CAncer gene 2) that are linked with hereditary breast cancer. The normal function of the BRCA genes is to keep cells growing normally and to help prevent breast cancer. When the BRCA genes are altered (possibly through genetic transfer) then the possibility of developing breast cancer in both men and women is increased. There is also an increased link to ovarian cancer for women and prostate cancer for men.
Some people choose to undergo genetic testing (blood testing) to find out if they have the altered BRCA genes. However simply having a proven gene abnormality does not necessarily mean that you will develop cancer, it may simply mean that you need to be more diligent with self examination and regular medical check-ups. Chatting to your doctor to talk through your options would be advisable.
It is important to note, that most people who develop breast cancer have no family history of the disease. However when a strong family history of breast or ovarian cancer is present, then there is an increased possibility of developing the disease - 10% of all breast cancers have a genetic link.
Who should have the test?
Not everybody needs to be screened for genetic risk of breast cancer. The best place to start is if your mum, aunt or sister has been diagnosed with breast cancer. Then find out if they have the genetic risk. If your mother or your sister has it then you may or may not have it. If your aunt had it but your mum doesn't then it couldn't be passed on to you.
In the event that there isn't any family history to help you decide, your family doctor or a genetic counsellor can help you work through the process of deciding whether or not to get screened. Either way the decision shouldn't be done or your own. Involve your family and a trusted medical professional.
No family history?
The BRCA genes are only one possible cause of breast cancer. In fact three quarters of women found with breast cancer have no family history, lumps or other symptoms. That's why it's important, if over the age of 50, to have a mammogram every two years. Also get to know your breasts and find out what is normal for you. That way you'll be able to spot changes. The Cancer Council recommends women, whatever their age, do a breast self-examination every month, and have their breasts examined by their doctor or women's health nurse every year.
To find more information on cancer or other medical issues, visit the lifestyle medical website medical articles or patient information sheets.
Australian Lifestyle Medicine Conference
If you are a member of the Australian Lifestyle Medicine Association (ALMA), work in the area of allied health or primary care or just interested to know more about this unique area from the leaders in Lifestyle Medicine check out ALMA's National Lifestyle Medicine Conference set for March 2010.
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