Medically Reviewed by Michael D. Pavy, MD

About one out of every 10 women carries the gene that can make them susceptible for breast cancer. McLeod Oncologist Dr. Michael Pavy explains the three types of breast cancer, how to find out if you carry this gene and what to do should you have it.

Here is a summary of Dr. Pavy’s comments:

There are genes that carry a breast cancer risk. We know one of them is called the BRCA gene. The other one is called the PALB gene. If women have these genes, they have a markedly increased risk of breast cancer – much more than the average woman.

There are three different kinds of breast cancer. “Sporadic” is when a woman walks in off the street with breast cancer and has no family history. That’s the most common. The second is called “Familial,” meaning they have the family history but when you test them for the gene, it’s not there. The third one is called “Hereditary.”

Sporadic is about 70 percent of women with breast cancer. Familial is around 20 percent of women. And, approximately 10 percent of women actually have the gene.

We provide genetic screening if a woman is likely to have the gene. And then, we have her seen by a genetics counselor. If she agrees, we draw blood and run a total panel of gene tests. This can give us a clearer idea of whether she will have breast cancer and, if needed, we offer her options.

If a woman has the gene, we recommend that when they are finished having their children, they have their fallopian tubes and ovaries removed, because the gene is also a marker for these cancers as well as breast cancer. You can’t pick up ovarian cancer early with any technique.

There are a number of different options you can talk about with women who have the breast cancer gene. One is to monitor them more often with MRI scans and mammograms. Then, we discuss whether they should take Tamoxifen. For some women there is the consideration about whether they should have prophylactic bilateral mastectomies to lower their risk of developing breast cancer.

This is a complicated area of oncology. There are a number of different points these women need to be counseled on. It also entails a lot of soul searching for each woman and her family of how they want to manage this situation.

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