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UNLOCKING YOUR FAMILY HISTORY - Bringing greater awareness about breast and ovarian cancer risk

Published: Synapse, 2010 - Vol. 2

Every woman is at risk for breast or ovarian cancer, but for some the risk is greater than for others. The level of each individual's risk depends on many factors. There is family history, genetics, environmental influences, age, lifestyle, and reproductive history. Thanks to recent advances in medical research, it is now possible to find out what your personal risk is for these diseases and what you can do to lessen that risk.

Know Your Risk FactorThe Cancer Risk Evaluation Program of the University of Pennsylvania, offered by The Women's Specialty Center at The Chester County Hospital, is specifically designed for women who want information about their likelihood for breast and ovarian cancers. The program offers individualized counseling and evaluation of personal and family risk, along with a full explanation of genetic testing and whether it is a reasonable option to pursue.

Because The Chester County Hospital is a member of the Penn Cancer Network, its staff has been able to benefit from training that allows the Hospital to offer the Cancer Risk Evaluation Program. The Abramson Cancer Center of the University of Pennsylvania is a national leader in the field of breast cancer genetics and has been selected by the National Cancer Institute as one of eight institutions chosen to conduct cancer genetics research on a national level.

Experienced in the most up-to-date procedures and cutting-edge technologies, the Hospital's team of highly skilled, compassionate cancer experts can help identify any factors that may place you or your family at higher risk for breast or ovarian cancer. The team can then provide you with options to help you reduce your risk. If genetic testing is deemed appropriate, they will coordinate the testing and make sure you understand the results.

"Women tend to overestimate their risk of cancer," says Jessa Blount, MS, CGC, Certified Genetic Counselor for the Cancer Risk Evaluation Program. "I tell women that when we look at their lifetime risk compared to national risk averages, their personal risk is often far less than they think it would be."

Jessica BlountAccording to Waleed Shalaby, MD, PhD, Gynecologist-Oncologist and Medical Director of the Cancer Risk Evaluation Program, there are external and internal factors that come together to raise a women's risk for breast or ovarian cancer. "Internal factors are the things going on inside the body like hormones, illnesses and genetics," he explains. "External factors are things outside the body, like the air we breathe, the environment we live in, and the food we eat."

Anything that increases your chance of developing cancer is called a risk factor, some of which you can control. For instance, if you are overweight, you can try to lose those extra pounds. If you smoke or use tobacco products, you can quit. Both steps may reduce your risk of breast and ovarian cancer.

"There are a variety of factors that can come together to increase a woman's risk," says Dr. Shalaby. "Once we identify the contributing factors in a women's life, we can determine her level of risk. Then we can help her make good choices about lifestyle and healthcare, and help her lower her risk."

Most women who develop breast or ovarian cancer have no family history of these diseases. In fact, only about 10-15% of breast and ovarian cancer cases are hereditary in nature. However, a family history of breast or ovarian cancer has been identified as one of the major risk factors for developing these diseases.

When a strong family history of breast and/or ovarian cancer exists, there may be reason to believe that an individual has inherited a BRCA1 (BReast CAncer gene one) or BRCA2 (BReast CAncer gene two) mutation.

Endslow story"The job of BRCA1 and BRCA2 genes is actually to keep breast cells growing normally, but when these genes contain abnormalities, or mutations, they are associated with a much higher than average risk of breast cancer and ovarian cancer," says Pamela Scott, MD, Breast Surgeon and Medical Director of The Women's Specialty Center and the Hospital's Breast Health Program. "Women who inherit a mutation in either of these genes from their mothers or their fathers have a much greater than average risk of developing these cancers."

More and more women are deciding to learn whether or not they have an abnormality in their breast cancer genes, but it is important to remember too that family history alone is not the only reason people get cancer. Many other factors come into play. And, the more risk factors a woman has, the more likely she will develop breast cancer or ovarian cancer.

"The reason cancer develops is often unknown, but it may be caused by a combination of factors, including environmental exposures or lifestyle," says Blount. "We are fortunate that we are now able to take steps that reduce our overall risk."

By Beth Eburn

To learn more about the Cancer Risk Evaluation Program, call The Women's Specialty Center at 610.423.4556.

Breast and Ovarian Cancer

Breast cancer is the second most common form of cancer. It is also the second leading cause of cancer deaths for American women, but the disease is also highly treatable when diagnosed in the early stages. It may be surprising to some, but men can also develop breast cancer -- although it is seen far less often. While ovarian cancer is much less common than breast cancer, it is considered the deadliest of gynecological cancers. It is more life-threatening and harder to diagnosis early, because of its subtle symptoms. Ovarian cancer is often diagnosed in its later stages when treatment options are limited. However, if patient carries a BRCA 1 or 2 mutation prophylactic surgery to remove the ovary and fallopian tube can provide up to a 96% risk reduction for developing ovarian cancer.

Last Updated: 10/15/2010