3 generations of breast cancer

sadandscared

I am 31.  My maternal grandmother's aunt died of breast cancer.  My maternal grandmother died of breast cancer. And I just found out today that my maternal grandmother's daughter has been diagnosed with stage 4 breast cancer.  I  previously told my doctor that there is a family history of breast cancer (2 generations) and he seemed dismissive saying that I should self examine  and that they usually do not screen women until they are in their 50's.  Now there is 3 generations and my aunt who just received the diagnosis is 43.  What should I say to my doctor at my next visit?  Are there specific tests that I should ask for?

wishiwere

I would make an appt with a breast care clinic that is more up to date most likely than your general practicianer.  They'll know more about the generational thing and what you should do at this point.  But I think the guidelines are to start mammo's 10 years before the youngest affected relative was dx at.  In other words, since your aunt was dx at 43, you would start at 33, but I'm not sure if that holds true for an aunt as she was would be considered a second-line relative.  Not your own mom or sister. 

someone with more knowledge on this will be by most likely to offer more guidance, and if they don't, try to post on the forum for genetic risks...High risk maybe?

Traci-----TripNeg

Hi sadandscared.

First, I'm sorry about your family history. I've got one too. It sucks.

You should be tested for the BRCA genes at the very least. You can google info on it although, don't let anything you read scare you. It is good that you are concerned.

If your doctor doesn't want to be aggressive, find another doctor! Be your own advocate. Knowledge is power girl.

Hugs, Traci

p.s. Don't "over" self exam. My little sister got breast cancer and so I was examing myself all the time. Too often. When my lump was small, I didn't feel it because I was feeling myself almost literally, every day and so didn't feel the slight change. By the time I felt it, it was large and, there  was another little one right beside it.

mela4409

Sorry that this is happening in your family.  I am the 4th generation in my family to have breast cancer, and we don't carry the BRCA 1 or 2 gene, they think it is another gene mutation.  My family members all got breast cancer in their 40s and here I am age 24 with breast cancer.  If you are feeling that you want to be screened early, you should talk to a breast center or another doctor about starting Mammograms early.  My cousin's mom died from breast cancer and she has had 3 biopsy's in the last few years (all b9) and she is only 29, she is now having a preventative bilateral mast. because of our history.   Make sure you feel at ease where ever you end up going!  It's so important for you not to feel nervous or scared about the future!

AngelaD

Hello - 

I agree with all of the posts above and you might want to check out the myriad labs website with a breakdown of the odds and descriptions:  http://www.myriadtests.com/provider/brca-mutation-prevalence.htm

hope this helps.  I tested positive this summer for BRCA 1 with a family history similar to yours.  Good luck - take care of yourself and be your own advocate.  Docs hedge on the test because it costs $3500.   There are other payment arrangements that are made for insurance problems (I've been told)

All the best. 

roseg

I think starting mammograms early is your best defense.

WishIwere notes that breast cancer often turns up about 10 years earlier in a daughter. A mammogram is much less expensive than other tests so you're more likely to get that approved by insurance.

I would also take a look at my lifestyle. Don't let yourself gain a lot of weight and be sure you avoid extra estrogens.  Now is the time when these changes can help.

dlb823

Hi ~  If you are close to an NCI-designated cancer  hospital with a breast center, I would definitely get an appointment for a consultation. 

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html 

My sister and 2 cousins had bc, but my primary doctor totally downplayed that their bc would have any affect on my chances of getting it.  The same doctor also had me on HRT, which I've since learned significantly increases your chances of developing bc if you have a close relative who had it.

After I was dx'd, I ended up at a teaching university breast center for tx, and learned that they have a High Risk Program that evaluates and closely monitors women with a family history of bc.  I can't help but think that if I had known about this program earlier, I might not have had to have a mastectomy and chemo and everything I've had to go through this year.

Mammograms are a start, but I would encourage you to seek out doctors who deal with situations like yours on a regular basis, and have a program and experience to not only monitor you closely, but give you peace of mind, as well.

Take care ~   Deanna 

Jo_Ann_K

Sadandscared,

My mom had breast cancer, her mom and all her sister had female-hormone related cancers and I was diagnosed with breast cancer last month.  So I made an appointment with a genetics counselor associated with the Breast Cancer Center and had all the gene tests done, more for my two daughters, than myself.  I was thankfully negative, but if I had been positive, it would have resulted in my daughters starting their surveillance immediately as they are both in their 20s, having regular breast MRIs in addition to yearly physical breast exams. 

There is a great website that can address your risk questions specifically that you'll want to check out.  It's acronym is FORCE and the URL is http://www.facingourrisk.org/

The key is not to fret about the unknown, but to become as knowledgeable as you can. Knowledge is power!

fearnot

Jo_Ann_K,

The fact that you tested negative does not necessarily mean you don't carry a gene mutation.  I also have a significant family history and my sisters with bc tested negative for BRAC 1 & 2 as well as the less known BART test.  The genetic counselor I consulted is absolutely convinced that BC is genetic in my family - so much so that I am going the route of surgerical removal.  From my understanding, a negative test result is only meaningful when a relative with BC tests positive and then you test negative  but if someone  with bc tested negative, it doesn't really provide a conclusion answer.

Sadandscared, 

I am in the very same boat and I can tell you that breast health really falls thru the cracks between the different doctors.  I asked a few obgyns for help figuring out the best game plan for me and mutilple drs failed to give me any answers so I finally went to a High Risk Program at a big city cancer center to get answers - even basic ones like what's the gold standard of imaging tests that I should be using (answer: alternating mri with mamo/ultrasound every 6 months).  Please, please don't fall into a sense of complacency like we did in our family while we watched another and another family member get dx. Get the facts from a cancer center not from an obgyn!!!!!

sadandscared

Thank you everyone for your responses and guidance regarding additional information.  My heartwarmed wishes go out to you and your families. 

Deirdre1

Say - it's time to send me to a genetic counselor and no but's about it.. and they might suggest a breast MRI - and of course BRCA 1/2 testing (as other's have said).  But family history as strong as this needs the attention of a up to date doc.  If you have a University near you you might want to call their "Women's Health" dept..  Good Luck

cp418

http://www.medicalnewstoday.com/articles/129801.php

Deirdre1

CP418:  Thanks for this link it actually addresses several threads in the section! Best