Northern Genetics Service

Breast cancer in the family - without an increased risk

Information for women without an increased risk of breast cancer

 

Breast cancer in the family – what does this mean?

Breast cancer is the most common cancer affecting women in the UK. Many of us will either have a relative with breast cancer, or know someone who had breast cancer. The great majority of breast cancers are not inherited. This leaflet aims to answer some of the questions you may have about your family history of breast cancer. You may have had breast cancer yourself. If you have, this leaflet may be relevant to your family members.

How common is breast cancer?

About 50,000 women are diagnosed with breast cancer in the UK each year. Women

have about 1 chance in 8 (12.5%) of developing breast cancer during their lifetime. More than 80% of women who get breast cancer are over 50 years of age. The chances of surviving breast cancer are greatly improved; more than 80% of women are alive more than five years after cancer treatment.

How often is breast cancer inherited?

Very few women (about 5%) have breast cancer because of an inherited tendency. Most breast cancers occur due to chance and are not inherited.

How do we recognise inherited breast cancer?

It is very unusual to have an inherited tendency to develop breast cancer. It generally only occurs in families where:

  • several close relatives developed breast cancer or
  • individuals had breast cancer at younger ages than is usual or
  • some relatives had breast cancer and others developed ovarian cancer or
  • one relative had both breast and ovarian cancer.

In families like this, there may be an altered gene that means people are more likely to develop breast cancer than usual.

Is the cancer in my family inherited?

When we look at your family history we look at the number of relatives who have had cancer, and their ages when they developed it. Cancers occurring at older ages are less likely to be inherited. The types of cancer are also important as only certain types are related to each other. Many cancers, such as lung cancer and cervical cancer, are usually due to environmental rather than genetic effects.

From the information you have given us, the cancers in your family are unlikely to be due to an inherited tendency. It is more likely that the cancers in your family occurred due to chance.

This may be because you only have one or two relatives who have had related types of cancer, or because the cancers have occurred at older ages. If the cancers in your family are in more distant relatives, the risk for you is less likely to be increased, especially if your close relatives have not developed cancer.

Should I be having extra screening?

No. Women without an increased risk are not usually advised to have breast screening before the age of 50. Between the ages of 50 and 70, every three years mammograms are offered on the NHS National Breast Screening Programme.

What are mammograms?

Mammograms are carried out at your local breast care clinic or screening unit. A small dose of x-rays is used to examine each breast. Having too many x-rays is potentially harmful because it may increase the risk of cancer. However, where the family history indicates an increased risk of cancer, the benefits of regular mammograms will outweigh the risks.

Mammography may also detect other changes in the breast which are completely harmless. Occasionally this can result in someone being recalled for further tests such as a biopsy. This may cause some anxiety but most often these turn out to be normal.

Mammograms do not always pick up breast cancers. This is particularly so in younger women because their breast tissue is often more dense than in older women. It is still not clear if mammography before the age of 50 is beneficial. In time we expect further medical research will be able to answer this question.

Can I have a genetic test for breast cancer inheritance?

It is quite unusual for us to be able to identify a genetic cause even when several people in the family have been diagnosed with breast cancer. This is more likely if three or more close relatives on the same side of the family have developed breast cancer, or sometimes breast and ovarian cancer. These will usually have occurred at younger ages (before the age of 50).

As the cancers in your family are unlikely to be inherited, genetic testing is not likely to be helpful in your family.

What breast symptoms should I look out for?

In most women, breast cancer is first noticed as a painless lump in the breast.

Other signs may include:

  • a change in the size or shape of a breast
  • dimpling of the skin of the breast
  • a thickening in the breast tissue
  • a nipple becoming inverted (turned in)
  • a lump or thickening behind the nipple
  • a rash (like eczema) affecting the nipple
  • a blood-stained discharge from the nipple (this is unusual)
  • a swelling or lump in the armpit.

Pain in the breast is usually not a symptom of breast cancer. In fact, many healthy women find that their breasts feel lumpy and tender before their period. Some types of benign breast lumps can be painful. Often there are no outward signs of breast cancer that you can see or feel.

Even if you do have one or more of these signs, it still doesn’t mean you have breast cancer. Most breast lumps turn out to be benign (not cancerous). However, it’s important that you tell your doctor immediately if you experience any worrying symptoms.

Can I do anything to reduce my risk?

Some lifestyle factors are thought to reduce the risk of breast cancer. Maintaining your weight within normal limits may help. Evidence indicates that obesity does increase breast cancer risk, particularly after the menopause.

Drinking excessive alcohol may increase your breast cancer risk. The Department of Health guidelines state that women should not consume more than two to three units of alcohol a day. Smoking may also increase the risk of breast cancer.

There is good evidence that frequent physical exercise reduces cancer risk. A balanced diet including plenty of fruit and vegetables is also recommended.

How do hormones or environmental factors affect my chances of breast cancer?

Our knowledge of the causes of breast cancer has greatly improved. Unfortunately, we still do not understand all of the environmental factors that affect the chances of developing breast cancer. We do know that certain hormonal factors are important because they may increase the risk of breast cancer. They are:

  • starting your periods early (under 12)
  • having a late first pregnancy (over 30)
  • having no children
  • having a late menopause.

There is evidence that breastfeeding for a total of 12 months or more may reduce the risk of breast cancer.

Research has shown that taking the Oral Contraceptive Pill does not significantly alter the risk of breast cancer. There might be a slightly increased risk while taking the pill but the added risk will reduce within a few years of coming off the pill.

There are some concerns about Hormone Replacement Therapy (HRT) and breast cancer. If taken for more than five years after a natural menopause, combination HRT, containing oestrogen plus other hormones, does increase the risk of breast cancer. The longer HRT is taken, the greater the increase in risk. Again, the added risk decreases once HRT is stopped. Using HRT to manage menopausal symptoms is a very personal decision. You will need to talk about this with your GP or gynaecologist.

What about my relatives?

We have assessed that the cancers in your family are unlikely to have an inherited cause. It is therefore unlikely that your children or other relatives will inherit an increased tendency to develop cancer.

If there is a history of cancer on your partner’s side of the family then they may wish to discuss with their GP whether they would also like to be referred to us for assessment of their risk.

What should I do if someone else develops cancer?

If any other members of your family develop cancer, or if you uncover any information about cancers further back in the family, it’s important to update us as it may change our advice to you.

Useful websites for further information:

http://www.cancerresearchuk.org/about-cancer

http://www.macmillan.org.uk

http://www.breastcancercare.org.uk

http://www.againstbreastcancer.org.uk

http://www.nhs.uk (NHS Choices)

 

Contact Patient Advice and Liaison Service (PALS) if you need confidential advice or support on: Freephone: 0800 0320202     Email: northoftynepals@nhct.nhs.uk

 

The Newcastle upon Tyne Hospitals NHS Foundation Trust is not responsible for the content of third-party information and does not endorse any product, view or process or opinion from such sources.

This leaflet is based, with permission, on a leaflet produced by the West Midlands Regional Genetics Service.

Publication Date: January 2016

Review Date: January 2019


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