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Medical Forum / Diseases and Disorders / Breast Cancer / May 2008genetic odds
My wife is 58, had her first child at 36, her mother had breast cancer and her 56 year old sister has just been diagnosed with it. Is there some sort of formula I can plug information like this into to get an idea of her chances of being diagnosed? Or, just considering the mom and sister, how much does that increase my wife's odds? Thanks. No formula, but your sister in law and mother in law can get tested for the BRCA 1 and BRCA 2 gene. If they test positive you wife could get tested. > My wife is 58, had her first child at 36, her mother had breast cancer > and her 56 year old sister has just been diagnosed with it. Is there > some sort of formula I can plug information like this into to get an > idea of her chances of being diagnosed? Or, just considering the mom > and sister, how much does that increase my wife's odds? Thanks. > My wife is 58, had her first child at 36, her mother had breast cancer > and her 56 year old sister has just been diagnosed with it. Is there > some sort of formula I can plug information like this into to get an > idea of her chances of being diagnosed? Or, just considering the mom > and sister, how much does that increase my wife's odds? Thanks. These factors will only give you a small deviation from the baseline risk. The family history on its own only adds a little to the risk, across the population. It is more significant for certain races. With only two instances to consider, it is hard to draw any statistical conclusions at all. The probability of such a configuration coming up by random chance is quite high. You really need to go further back along the family tree and look for a significantly high incidence, especially of close relatives contracting the disease at a pre-menopausal age. To make an overall assessment of the risk you also need to take into account such risk factors as race, body mass index, HRT, alcohol, night work, etc. etc. Even then a large proportion of occurrences of breast cancer remain "unexplained" or "random". Opinions differ, but I've heard say that only about 30% of cases can be 'explained' by known risk factors. The biggest single risk factor is 'getting old'. Tim Jackson > xxffxxwrote: > > My wife is 58, had her first child at 36, her mother had breast cancer [quoted text clipped - 21 lines] > > Tim Jackson Thanks, Tim. Articulate and very helpful. Any more of the risk factors you could list, with details, would be highly appreciated. >> xxffxxwrote: >>> My wife is 58, had her first child at 36, her mother had breast cancer [quoted text clipped - 23 lines] > Thanks, Tim. Articulate and very helpful. Any more of the risk > factors you could list, with details, would be highly appreciated. The major 'medical' risk factor is estrogen exposure. Many of the other factors come down to that - obesity increases estrogen because it is synthesised in fat (as well as ovaries and elsewhere). Shift work etc. because of an interaction between the sleep hormone melatonin and estrogen levels. Childbearing and breastfeeding provide protection by depressing estrogen. Exposure to certain pollutants which mimic estrogen increases the risk this way. The biggest risk factor of all is to have already have had breast cancer. Using estrogen blocking drugs cuts the risk for these women by half. However the side effects and increased risk of other conditions makes these drugs inappropriate for the general population. The recognised genetic factors, the BRCA gene mutations are I understand mainly prevalent among those with Jewish ancestry. There are other genetic factors being studied, but their implications are not yet well known. Not by me anyway. Regular alcohol consumption is known to increase the risk. Other factors, like exposure to ionising radiation (eg x-rays and isotopes, not microwaves or cellphones) tend to be difficult to quantify. Tim > The biggest risk factor of all is to have already have had breast cancer. > Using estrogen blocking drugs cuts the risk for these women by half. > However the side effects and increased risk of other conditions makes > these drugs inappropriate for the general population. Not true for women with estrogen negative cancers, estrogen blocking drugs have no effect and are not recommended. This is true for women who had cancer that was sensitive to estrogen to begin with. Alex >> The biggest risk factor of all is to have already have had breast >> cancer. Using estrogen blocking drugs cuts the risk for these women by [quoted text clipped - 5 lines] > This is true for women who had cancer that was sensitive to estrogen to > begin with. Fair comment, there is no reason why having had an ER- cancer should increase your risk of getting an ER+ one, so the benefit in that case would be no more than for the general population, and the statistics would seem to bear that out. And indeed that treatment is only recommended for ER+ patients. Although back when my wife was a patient in the UK they didn't actually do the test, they gave her Tamoxifen regardless. I think it's ineffectiveness for ER- had not yet been fully established. However it can't be quite as simple as saying that reducing estrogen exposure only reduces the risk of ER+ cancers. You would then expect a much higher proportion of second primaries that happen while taking estrogen blockers to be ER-. Of course it is hard to identify what is a second primary, but last time I looked the statistics did not seem to support that hypothesis. The relationship seems more complicated. Tim If there is a familar trait the risk of Breast Cancer is higher. http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA The risk factors you cite below are correct they are not strong variables. The initial question was, there is a family history. I assumed the concern was for a familiar breast cancer. Having the relatives tested would answer that question. To be tested for the gene, one needs to be seen by a genetic counselor who will evaluate the need to proceed for the BRCA testing. The work with the oncologists to determine where or not the cancer follows a pattern that is constistent with BRCA mutations. Otherwise you are correct there is little value with the other risk factors although, there is link to do an assessment. http://www.cancer.gov/bcrisktool/ >> My wife is 58, had her first child at 36, her mother had breast cancer >> and her 56 year old sister has just been diagnosed with it. Is there [quoted text clipped - 20 lines] > > Tim Jackson > ... The biggest single risk factor is 'getting old'. OY! It's my 69th birthday today! :-) Mary >> ... The biggest single risk factor is 'getting old'. > [quoted text clipped - 3 lines] > >:-) Happy Birthday Mary! I was 64 last month.  Signature"It's easier to get forgiveness than permission." Rear Admiral "Amazing" Grace Hopper >>> ... The biggest single risk factor is 'getting old'. >> [quoted text clipped - 5 lines] >> > Happy Birthday Mary! I was 64 last month. I reckon we're both doing well! Mary >>>> ... The biggest single risk factor is 'getting old'. >>> [quoted text clipped - 3 lines] >>> >>>:-) And my birthday is tomorrow, Happy Birthday Mary. >> ... The biggest single risk factor is 'getting old'. > [quoted text clipped - 5 lines] > > Mary So? It's my son's 27th too. It was my 57th on Monday. We redefine "old" as we age, to mean older than us, I reckon. Tim >>> ... The biggest single risk factor is 'getting old'. >> [quoted text clipped - 10 lines] > > We redefine "old" as we age, to mean older than us, I reckon. Yes, it's interesting isn't it! A neighbour once told me how sorry she was that someone in the street had died, at so young an age. 57. I didn't understand then. I do now :-) Happy birthday to EVERYONE! Mary Mary > Tim > We redefine "old" as we age, to mean older than us, I reckon. boy, not me, I call myself old, and I feel old, and I think I am old. that having been said, there is a common saying that it takes 10 years to get used to how old you are. my dad died at 48.....many think that is young....it's young to die, but he wasn't a young man. Young is 30s or 20s. > Tim >> We redefine "old" as we age, to mean older than us, I reckon. So do I. That is, I used to ... > boy, not me, I call myself old, and I feel old, and I think I am old. So do I - but people tell me I don't look my age. I reply that I don't know how I'm supposed to look at my age ... Mary >> Tim >>> ... The biggest single risk factor is 'getting old'. >> [quoted text clipped - 10 lines] > > We redefine "old" as we age, to mean older than us, I reckon. Indeed. It was our baby son's fortieth yesterday! I thought about you today, I took part in the Biobank survey and an additional Heart Something test/advice. I was told that with my profile I had a 20% risk of having a heart attack or stroke. I said Oh good, that means that I have an 80% chance of not having one. The nurse had never thought of it that way ... :-) Mary trying to reduce my flagged messages > Tim Sorry, everyone, I thought that was going to Tim personally, not the group! Mary > My wife is 58, had her first child at 36, her mother had breast cancer > and her 56 year old sister has just been diagnosed with it. Is there > some sort of formula I can plug information like this into to get an > idea of her chances of being diagnosed? Or, just considering the mom > and sister, how much does that increase my wife's odds? Thanks. There are several levels of genetic testing, depending on how far you want to go, how strongly you are urged to do it, and how much you are willing to spend depending on your insurance. Genetic counselors make risk charts and suggest what you should do. Ashkenazi Jews have higher risk factors than the general population; I've also learned that having a MALE relative with BC is another factor. But as somebody said above, most people with BC have nno obvious risk factors. DEB How do we know? We're not geneticists but a suffer support group... María > My wife is 58, had her first child at 36, her mother had breast cancer > and her 56 year old sister has just been diagnosed with it. Is there > some sort of formula I can plug information like this into to get an > idea of her chances of being diagnosed? Or, just considering the mom > and sister, how much does that increase my wife's odds? Thanks. I had breast cancer in one breast and thank God it was caught very early by a mamogram. I went ahead and had both removed to prevent the chances of it returning. When they did my biopsy they found that I had Estrogen and Progesterone receptors in my body. I took birth control for about 12 years and estrogen for 10. The Estrogen did not cause my cancer but fed it thru those receptors I had in my genes. I have let everyone in my family know that they should never take Estrogen or birth control. So the genetics and Estrogen put my odds right up there. I do have a question tho. Can progesterone have anything to do with cancer? Mora > I had breast cancer in one breast and thank God it was caught very early > by a mamogram. I went ahead and had both removed to prevent the chances [quoted text clipped - 9 lines] > > Mora Hi Mora, Did you have genetic testing? The results they give you are not related to estrogen or progestone. They will tell you that a mutation at a certain location is present or not. A genetic counsler will spend hours with you explaining all this. In a way you are lucky to have a hormone sensitive cancer it responds to more treatment. No I never had genetic testing. My cancer is now gone. I am just having a lot of problems with infection and getting rebuilt. Mora |
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