what makes you high risk???

Yes, all 1st line family members with Breast cancer increase your risks.  Your mothers, sisters and such.  2nd line are included when there are smaller families in your background.  Like no maternal aunts, or such.  There's a site that explains a lot of it:  http://www.myriadtests.com/quiz.htm?s=Completed

Christine,

When geneticists see a pattern of multiple cases of BC or ovarian cancer in a family, they start thinking that the development of BC or ovarian cancer in that family is associated with a mutation in one of the BRCA genes.  The BRCA1 and BRCA2 genes are "tumor suppressor" genes--they encode factors that cells use to repair damage to their DNA.  DNA damage occurs all the time in cells.  If the damage does not get repaired or the affected cell is not killed, that cell can begin to grow uncontrollably and can become cancer.  So, a mutation in one or both of the BRCA genes can result in a greatly increased risk of developing BC or ovarian cancer, and possibly other types of cancer.  That's why a familial pattern is important.

wishiwere has given you a link to the Myriad Genetics website.  That's the company that does genetic testing for BRCA1 and BRCA2 mutations here in North America.

Please note that on the page wishiwere cited, "risk" refers to the risk of developing a hereditary form of cancer, not the risk of developing cancer in general.  The same is true for the information I'm giving below--"risk" refers to the risk that an individual has a BRCA mutation; it doesn't refer to the overall risk of developing BC.  There are many things that can contribute to a risk of developing BC, and a mutation in the BRCA1 or BRCA2 genes is one of them.

There is some other information on the Myriad site that's relevant to your situation.  For instance, there is a page on the site that has a table showing the likelihood of finding a BRCA mutation in an individual, depending on whether that individual already has ovarian cancer or BC and the age at dx, plus the number of 1st- or 2nd-degree relatives with BC or ovarian cancer and the age at which it was dx'd in those relatives.  First-degree relatives are your full brothers and sisters, parents, and offspring, but not half-siblings.  Second-degree relatives are one step farther away--i.e., your aunts and uncles (your parents' siblings), nieces and nephews, grandparents, and half-siblings.

A dx of ovarian cancer at any age in a 1st- or 2nd-degree relative adds to the risk that a person has a BRCA mutation; but the risk contributed by a dx of BC in a relative depends on the relative's age at dx.  A dx of BC before age 50 in a 1st- or 2nd-degree relative adds significantly to the likelihood that it is BRCA-related.  OTOH, a dx after age 50 in that same relative adds much less and isn't even considered in the risk calculations done by the Myriad Genetics formula.  Look at the table on this page to see some specific numbers:

http://www.myriadtests.com/provider/brca-mutation-prevalence.htm

Here's an on-line calculator on the Myriad Genetics site. You can plug in your own data to see the likelihood that you have inherited a BRCA mutation.  Many geneticists use this calculator or others like it to decide whether BRCA testing is warranted:

http://www.myriadtests.com/provider/brca-risk-calculator.htm

The BRCA risk calculation is important because some insurance companies will not pay for BRCA testing unless the likelihood of a mutation is above a certain percentage.  My onco surgeon said she thought the threshold was 10%; but my calculated risk was only 5.3% and my insurance paid for the test.

Here is a more general calculator that estimates an individual's risk of developing BC:  http://www.cancer.gov/bcrisktool/

Note that the question about BC in first-degree relatives says nothing about their age at dx, and the calculation does not include BC in 2nd-degree relatives.  Also, the calculator does not even ask about ovarian cancer in relatives, which I think is kind of odd.

I hope this helps in your decision-making.

otter 

Otter and Beesie, you ladies are brilliant I find your posts so darn easy to understand thank you.  I am waiting for my BRCA 1 or 2 results and since I first noticed the lump when I was 47 and my family is Askinazi Jewish I'm pretty sure I will end up as positive for the gene. I even bet my genetist a Tim Horton's coffee.  The reason I want to know is that my family will all be tested, if they choose to do that, if I am positive. And for me an early warning system for my sons, sisters, and brother is comforting and could at the very least save their lives just by knowing and reducing their risks. So I have to wait for the test to come back, the genetist said it could take up to four months though. So I hope to know by the end of August and one way or another it will just be a relieve to me to know if my family has a high risk factor as well.     

Beesie, my BRCA testing was billed at more than $3,000 U.S.  It was that high because I was the first person in my lineage to be tested, so they had to do the entire sequence of both genes to check for mutations.  I tested negative, fortunately.  If I had tested positive for a mutation, then subsequent testing of my family members would have cost only about $350 because the lab would already know exactly what mutation to look for.

Oh, I just re-read your post, and now I understand that the $200 would have been for a "rush order"!  It took exactly 2 weeks for my results to come back.

otter