Worried about my 13 yr. old daughter and her risks

You should pursue BRACA 1/2 genetic testing to see if your family has the mutation, and your husband can as well. Knowledge is power.

Your daughter's risk can be managed by making sure she maintains an ideal weight. You didn't mention if she has started menstruating. Higher risk is associated with early onset of menstruation, as it is more years that the breast tissue is exposed to estrogen. There's nothing you can do about early menarche - risk wise - except letting her know how important it is to maintain a healthy weight. Fat tissue produces an estrogen (estradial) that can also flood the breast tissue.

Some studies have indicated that exposing the breast area to sunlight at an early age has some protective effect. She's 13 now, so she'd probably die before hitting the back yard topless, but if she is game, give it a shot.

Staying away from estrogen in her diet might be a good idea. American factory farmed beef is still estrogen supplemented as part of the feed lot process, so I'd keep any girl of mine from cheap beef. Chicken is not allowed to be hormone supplemented, but the beef lobby is kicking its feet at any legislation in that direction. As far as I know, lamb and goat aren't estrogen supplemented, and I am not sure about pork.

Controlling her blood sugar is important, as early data is pointing to insulin overproduction as contributing to many reproductive cancers. Keeping a healthy diet going, and avoiding fruit juices and sugared sodas would be good.

Now, if you want to get super persnickity, avoid BPA in food cans. BPA functions as an artifical estrogen in the body, and promotes insulin overproduction. Most canned foods come in cans lined with a BPA epoxy resin to keep the foods from tasting metallic. All canned beverages are still laced with BPA from the lining. Store your leftovers in glass containers, and never microwave foods in plastic plates or containers. All plastic containers will leach BPA (or other suspicious plasticizers) into food when exposed to acid (like tomato sauce) or heat. Canned tomato soup is a festival of BPA. I know this sounds crazy, but the data is pretty clear about BPA. The legislation to address this is slow, as most food producers really love their plastics.

You can manage her risk. Keep her lean, and make sure she gets at least 30 minutes of exercise a day. Stay away from cheap beef and sugary beverages. Get sun. Avoid canned foods and all foods heated in plastic.

There is some concern about parabens in cosmetic products. It's a correlation issue: parabens are seen in cancerous breast tissue at a higher rate than in normal tissue. The thinking seems to be that the parabens are also functioning as an artifical estrogen in the body. But, most companies are getting wise to that concern now, so just read the ingredients (it's usually towards the bottom of the list). Parabens are used as a preservative, and can be easily replaced with Vitamin E to achieve the same effect.

My family has been full of cancer too, and I have a 13 year old son, so I've been thinking about these things A LOT.

Take care,

Jennifer

Maryann, 

Most breast cancer is random, not genetic.  One in 8 women in North American will develop breast cancer at some time during their lives, so in most families you are bound to eventually find one or two women who've had or who develop breast cancer.  Usually it does not mean that any other women in the family, especially those who are not first line relatives, are higher risk.  But it could.

So there are things that you have to look at, other than just whether any of the women in the family have ever had breast cancer.  

• Were your mother and your daughter's grandmother diagnosed prior to menopause or post-menopausally?  A diagnosis at a younger age is more likely to indicate a possible genetic cause, whereas a diagnosis post-menopausally is more likely to be random.  
• Are there other cancers in your family or your daughter's father's family?  Breast cancer, ovarian cancer, prostate cancer?  There are other cancers that are also linked to the 'breast cancer gene' but those are the most common cancers.  If no one else in those family lines have had these types of cancers, then the odds are that the breast cancer was random and not genetic. 

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Generally breast cancer risk is considered to be increased, either because of the possible presence of a known breast cancer gene, or because of some other genetic connection, if someone has a first degree relative, a mother or sister (or father), who's had breast cancer.  Second degree relatives such as grandmothers and aunts don't present as much of a risk, although if there are a number of second degree relatives who've all had related cancers, that could be an indication of a genetic cause.  So having two grandmother's with breast cancer might not increase your daughter's risk at all, if the cancers are not genetically based.  Even if it's found that one of her grandmother's does carry a breast cancer genetic mutation, it still doesn't mean that your daughter has inherited it and therefore has a higher risk. The BRCA gene is inherited either from one's mother or one's father.  So if your daughter's paternal grandmother carried the gene, there was only a 50% chance that she would have passed that gene on to your daughter's father.  If he didn't inherit it, then your daughter can't have it.  But if he did inherit it, there's still only a 50% chance that your daughter inherited the gene from him.  

So, all that to say that your daughter's risk because of her two grandmother's is probably not significantly increased, if it's even increased at all.  My suggestion however is that you talk to a genetic counsellor, who can provide a lot more information about this, and who can look more closely at the family health history.  If there does appear to be a reasonable risk that the BRCA genetic mutation might be in either side of the family, then you and/or your daughter's husband could be tested for the gene.  If one of you have it, then eventually your daughter should be tested.  But if neither of you have it, then your daughter won't have it either. 

Here are a couple of links with information that might be helpful and that hopefully will ease your mind:  

Family History of Breast, Ovarian or Prostate Cancer

Definite Breast Cancer Risks:  Family History  This site provide one of the clearest and easiest to understand explanations of breast cancer risk as it relates to family:

"Having a mother or sister diagnosed with breast cancer approximately doubles the risk of breast cancer. But more than 8 out of 10 women who have a close relative with breast cancer will never develop it. 

When compared to the risk of the general population, you may have some increase in breast cancer risk if you have ONE of the following in your family

• A mother or sister diagnosed with breast cancer before the age of 40
• 2 close relatives from the same side of the family diagnosed with breast cancer – at least one must be a mother, sister or daughter
• 3 close relatives diagnosed with breast cancer at any age
• A father or brother diagnosed with breast cancer at any age
• A mother or sister with breast cancer in both breasts – the first cancer diagnosed before the age of 50
• 1 close relative with ovarian cancer and 1 with breast cancer, diagnosed at any age – at least one must be a mother, sister or daughter

The affected relatives must come from the same side of your family (either your mother's side OR your father's side) and they must be your blood relatives. A close relative means a parent, brother or sister, child, grandparent, aunt or uncle, nephew or niece."