Family history of recurrence

Yessica250426

Hello everyone- this is my first post after reading here over the past few weeks as I went through biopsies and testing that led to a DCIS, intermediate grade, ER/PR + diagnosis. Thanks for all of the solidarity! Your posts have helped me immensely!

I'm trying to decide between bilateral MX or lumpectomy/rads/Tamoxifen route. My choice is complicated by the fact that I'm in my early 30s and would like to have children. I'm BRCA negative.

I haven't been able to get a good answer from any doctors about the following question and I'm wondering if any of you all have seen any articles or resources that address this.

My paternal grandmother had breast cancer at 39 and another primary in her 50s. My paternal aunt had breast cancer at 38 and had a recurrence in her 50s. I know that with this family history I had a strong risk of getting breast cancer, but my question is with this family history of recurring breast cancer, is there also a heightened risk for recurrence?

Thanks!

MelissaDallas

There are genes besides BRCA that confer breast cancer risk. I would urge you to consult with a genetics counselor

Beesie

Yessica, you mention that your grandmother's second diagnosis was a new primary. Do you know if your aunt's second diagnosis was a new primary as well, or was it confirmed to be a recurrence? Recurrences (i.e. related to the original cancer) tend to be specific to the individual so I don't believe that a family member having a recurrence would increase the risk that you might have one too. The biology of the cancer and the treatment plan tend to be bigger factors.

However when assessing your risk of breast cancer based on heredity, if there are family members - particularly if more than one - who have been diagnosed with breast cancer more than one time (i.e. 2 or more unrelated new primaries, not recurrences of the original cancer) that's a big red flag that there may be an inherited gene in the family. As MelissaDallas mentioned, there are more 'breast cancer' genes than just BRCA. I recently was tested for 20 different genes. It's also understood that at this point in time, medical science has not discovered all the genetic mutations that may cause breast cancer (and other related cancers). So while I tested negative for 20 known genes, it doesn't mean that there might not be an as yet undiscovered gene that is causing the cancer in my family.

I agree that you should talk to a genetic counsellor. In addition to family members who've had breast cancer, they will want to know about other cancers that family members have had - ovarian cancer and prostate cancer are strongly linked to breast cancer, and other cancers (melanoma and colon cancer, as examples) may be linked as well.

If it's determined that you do carry one of the other genetic mutations, or if there is no mutation found but a very strong family history of related cancers, then this likely would increase your risk to be diagnosed a second time with a new primary breast cancer. But you really need a genetic counsellor to make this assessment.