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Breast Cancer

Breast cancer screening

01/02/2008

Question:

My sister(age 40) just died three weeks ago, from liver cancer; due to the spread of breast cancer. I had three aunts(in their 50`s and 60`s) who had breast cancer(two on my dad`s side; and one on my mom`s). Two of them died from it; the third, in an auto accident. Everyone`s pushing me to get a mammogram done. I`m only 34. My sister was 36, when she developed breast cancer. I feel I`m not old enough to get it done. What are your thoughts?

Answer:

You should absolutely get a mammogram.  I think that based on your family history there is a chance that your family has Hereditary Breast and Ovarian Cancer Syndrome.  This syndrome is characterized by many family members with breast and/or ovarian cancer and young ages of onset.  This may have been inherited from your father's side of the family.  It is caused by mutations in the BRCA1 or BRCA2 genes.  Unfortunately, it sounds like no one who has cancer is able to test for the syndrome, but genetic counseling might help to clarify your options.  Genetic counselors in your area can be found on the following web site:  www.nsgc.org.

I think that in addition to having a mammogram, you should see a breast surgeon who specializes in individuals at higher risk than the general population.  You should perform monthly breast self-examinations and have clinical breast examinations at least twice a year.  You may also be a good candidate for breast MRI for screening.  I generally recommend that breast screening start 5-10 years prior to the earliest diagnosis in the family for at risk relatives, so any other close female relatives should begin getting mammograms between the ages of 25 and 30.

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Response by:

Doreen M Agnese, MD Doreen M Agnese, MD
Clinical Associate Professor of Surgery and Internal Medicine
College of Medicine
The Ohio State University