Genetic Counseling and Breast Cancer
When Angelina Jolie, one of Hollywood’s best known stars, decided to pursue cancer prevention surgery of her breasts and ovaries it opened the eyes of the world to the procedure. While removing her breasts may have been a shocking approach to cancer prevention, her story was touching and heartwarming. Jolie’s grandmother, mother, and aunt all died of breast and/or ovarian cancer at far too young of an age. Once Jolie learned that she carried the same high-risk gene that lead to their cancers, known as BRCA1, she turned her story into one of empowerment.
The decision that Angelina Jolie made was a personal one, but her journey is similar to what many patients experience at Jackson Health System’s Familial Breast/Ovarian cancer clinic.
In October we recognize Breast Cancer Awareness Month. It is also the 16th anniversary of the Familial Breast/Ovarian cancer clinic, which helps identify and manage families at very high cancer risk due to inherited gene mutations. Only 5 to 10 percent of breast cancer results from an inherited mutation in the BRCA1, BRCA2, or other newly described genes. However, before it is indicated for you or your family, it is helpful to be prepared.
What is genetic counseling?
At Jackson, genetic counselors map out your personal and family history of cancer to assess the likelihood of an inherited cause including an altered gene being passed down, called gene mutation. We inform patients about genetic tests to understand cancer risks and discuss ways to screen for and reduce high cancer risks. We do this in a relaxed and supportive environment so patients can ask questions, become informed, make decisions about genetic testing, and learn about options for early detection and prevention that best suits the individual. When cancer runs in families, we pay attention to the entire family at all points in the life cycle.
Who should consider genetic counseling for inherited breast cancer?
If you have a family history of under 50 years of age, female or male breast cancers, or ovarian cancer, you might consider consulting with a genetic counselor. More than two individuals in the family with cancers diagnosed under age 50 is a red flag.
Certain ethnic backgrounds have higher rates of hereditary breast cancer. French Canadians, Eastern European Jews, and those of African-Caribbean descent have some of the highest rates of hereditary breast cancer due to ancestral mutations in BRCA1 and BRCA2 genes. So far, these same rates have not been seen in African-Americans, but scientists are still searching for answers to why African-American women have aggressive, early age breast cancers and whether new gene discoveries can provide answers.
What can you do?
Pay attention to your family history, speak to a genetic counselor, and know that you can turn histories of loss and feelings of fear to courage, hope, and strength for yourself and your family.
Genetic counseling empowers you to take an active approach to your own health.
Talia Donenberg, M.S., CGC, is a senior genetic counselor in the division of clinical and translational genetics for the University of Miami Miller School of Medicine. She and her team see patients at Jackson Memorial Hospital.