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What Every Woman Needs to Know about Breast and Ovarian Cancers

A little knowledge can go a long way in helping you understand your risk for breast and ovarian cancers. Once you learn your risk for these cancers, we hope you will talk to you doctor and develop a strategy to reduce your risk or detect these diseases at early, non-life-threatening stages.

Breast and Ovarian Cancer Basics

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the breast, it is called breast cancer. About 7 out of 100 women (or 7%) will be diagnosed with breast cancer by the time they turn 70 years old.

Ovarian cancer is far less common. About 1 out of 100 women (or 1%) will be diagnosed with ovarian cancer by age 70. Though it is less common than breast cancer, ovarian cancer causes more deaths than any other cancer of the female reproductive system.

About 5–10% of breast and 10-15% of ovarian cancers are hereditary. These hereditary breast and ovarian cancers are caused by inherited changes in genes such as BRCA1 and BRCA2.

Breast and Ovarian Cancer Basics for Young Women

While breast and ovarian cancers are most common in older women (about 89% of breast cancers occur in women older than 45 years of age), they can and do occur in younger women. There are some important differences when these cancers do affect young women:

  • Breast and ovarian cancers in young women are more likely to be hereditary (passed down through families and because of an inherited BRCA gene mutation).
  • Breast and ovarian cancers in young women are more likely to be diagnosed at a later stage and are often more aggressive and difficult to treat.
  • Young women can face unique issues when diagnosed, including concerns about body image, fertility, finances, and feelings of isolation.

Steps You Can Take Now

Learn More About Breast and Ovarian Cancers

Every woman can benefit from learning the risk factors and symptoms of breast and ovarian cancers.

Risk Factors for Breast Cancer at Any Age

If you have one or more of these factors, it does not mean you will get breast cancer. Talk to your doctor about ways to reduce your risk.

Reproductive Risk Factors

  • Being younger (before age 12) when you first had your menstrual period
  • Starting menopause at a later age (after age 55)
  • Being older (after age 35) at the birth of your first child
  • Never giving birth
  • Never breastfeeding for a long duration (1 year plus)
  • Long-term use of hormone replacement therapy

Other Risk Factors

  • Getting older
  • Personal history of breast cancer or some noncancerous breast diseases
  • Family history of breast cancer
  • Ashkenazi Jewish ancestry (ancestors from Central or Eastern Europe)
  • Treatment with radiation therapy to the breast or chest
  • Dense breast tissue – a condition that can be diagnosed by a mammogram
  • Being overweight (increases risk for breast cancer after menopause)
  • Having a mutation in the breast cancer-related genes BRCA1 or BRCA2
  • Drinking alcohol (more than one drink a day)
  • Not getting regular exercise

Symptoms of Breast Cancer

Pay attention to your body and know what is normal for you. If you have any signs that worry you, be sure to see your doctor right away.

  • New lump in the breast or underarm (armpit)
  • Thickening or swelling of part of the breast
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pulling in of the nipple or pain in the nipple area
  • Nipple discharge other than breast milk, including blood
  • Any change in the size or the shape of the breast
  • Pain in any area of the breast

Risk Factors for Ovarian Cancer

If you have one or more of these factors, it does not mean you will get ovarian cancer. Talk to your doctor about ways to reduce your risk.

If you have:

  • Reached or are past middle age
  • Never given birth or had trouble getting pregnant
  • A family history of ovarian cancer (mother, sister, aunt, or grandmother)
  • Ashkenazi Jewish ancestry (ancestors from central or Eastern Europe)
  • A mutation in the breast cancer-related BRCA1 and/or BRCA2 genes
  • Been diagnosed with breast, uterine, colorectal (colon), or cervical cancer or melanoma
  • Been diagnosed with endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body)

Symptoms of Ovarian Cancer

Pay attention to your body and know what is normal for you. See a doctor if you have any of these signs for two weeks or longer and they are not normal for you.

  • Vaginal bleeding or discharge from your vagina that is not normal for you
  • Pain in the pelvic or abdominal area (the area below your stomach and between your hip bones)
  • Back pain
  • Bloating, which is when the area below your stomach swells or feels full
  • Feeling full quickly while eating
  • A change in your bathroom habits, such as constipation, diarrhea, or having to pass urine very urgently or very often

Talk to your Doctor

The next time you visit the doctor, consider talking about what you have learned about breast and ovarian cancers.

Be sure to tell your doctor about your family history of cancer (especially breast, ovarian, fallopian tube, pancreatic, and prostate cancers) and about any other risk factors you may have.

If you need help collecting and organizing your family health history, use the U.S. Surgeon General's family health history portrait, https://familyhistory.hhs.gov/.

Together, you and your doctor can develop a personalized strategy to reduce your risk.

 

BRCA1 and BRCA2 Gene Mutations

What are genes?

Genes are the parts of the body that pass hereditary traits down through families. They contain information to build and maintain cells in the body. Genes are made up of a material called DNA. DNA determines certain characteristics (genetic traits) that are passed from parents to children, such as blood type, hair color, eye color, and risks of developing certain diseases.

What are BRCA1 AND BRCA2?

The names BRCA1 and BRCA2 stand for BReast CAncer susceptibility gene 1 and BReast CAncer susceptibility gene 2. BRCA1 and BRCA2 belong to a class of genes known as tumor suppressors. When functioning normally, these genes help keep breast, ovarian, and other types of cells from growing and dividing too rapidly or in an uncontrolled way.

When certain changes or "mutations" in the BRCA genes occur, cells are more likely to divide and change rapidly which can lead to developing cancer.

What are my chances of inheriting a BRCA1 or BRCA2 gene mutation?

If either your mother or your father has the BRCA1 or BRCA2 gene mutation, you have a 50% chance of having the gene mutation.

How many people in the United States have a BRCA1 or BRCA2 gene mutation?

About 1 in every 500 women in the United States has either the BRCA1 or BRCA2 gene mutation.

Are specific mutations in BRCA1 and BRCA2 more common in certain populations?

Yes. Ashkenazi Jewish women are ten times more likely to have a BRCA1 or BRCA2 gene mutation than the general population.

Other racial, ethnic, and geographic populations around the world, such as the Norwegian, Dutch, and Icelandic peoples, also have higher numbers of BRCA1 and BRCA2 mutations.

Is my risk for having a BRCA gene mutation the same thing as my risk for getting cancer?

No. Your risk for having a BRCA gene mutation is not the same as your risk for developing cancer.

Not every woman who has a BRCA1 or BRCA2 gene mutation will get breast or ovarian cancer, but having the BRCA1 or BRCA2 gene mutation puts you at an increased risk for breast and ovarian cancers.

  Breast Cancer Ovarian Cancer
General population

7 out of 100 U.S. women will develop breast cancer by age 70

Less than 1 out of 100 women will develop ovarian cancer by age 70

Women with BRCA1 or BRCA2 mutations

About 50 out of 100 women with BRCA mutations will develop breast cancer by age 70. Many of these cases of breast cancer will develop before the women turn 50 years old.

About 30 out of 100 of these women will develop ovarian cancer by age 70.

Source: Centers for Disease Control and Prevention ( http://www.cdc.gov/features/hereditarycancer)

It is very important to find out early if you have a BRCA1 or BRCA2 gene mutation, because early detection and early treatment can save lives. If you find out you have a BRCA1 or BRCA2 gene mutation, you and your doctor can discuss options to reduce your risk of developing cancer.

If you are not at an increased risk for a BRCA gene mutation, this does not mean that you have no risk for cancer. Only about 5-10% of breast and 10-15% of ovarian cancers diagnosed in the U.S. are associated with BRCA mutations. Other breast and ovarian cancers are due primarily to age.

How can I tell if I have the BRCA1 and BRCA2 gene mutation?

The only way to know if you have inherited a BRCA1 or BRCA2 gene mutation is to get genetic testing. You should meet with a trained genetic expert (e.g., genetic counselor, advanced practice nurse in genetics) and receive genetic counseling prior to genetic testing.

How do I know if I should get genetic counseling or testing?

Genetic counseling and testing is not for everyone. The tests are recommended for women whose family medical history has certain patterns of cancer. The Know:BRCA Assessment helps you determine if you are at an increased risk of a BRCA1 or BRCA2 mutation and might benefit from genetic counseling and further evaluation.

The list below describes the family history patterns that the Know:BRCA Assessment uses to determine if you fall into the 2% of women who are at an increased risk of a BRCA1 or BRCA2 mutation. Women who have none of these family history patterns have a low chance of having a BRCA1 or BRCA2 mutation.

Women who ARE NOT of Ashkenazi Jewish descent - If any of following apply, you are at an increased risk of having a BRCA mutation.

Do you have:

  • Two first-degree relatives (mother, daughter, or sister) diagnosed with breast cancer, one of whom was diagnosed at age 50 or younger
  • Three or more first-degree or second-degree (grandmother or aunt) relatives diagnosed with breast cancer regardless of their age at diagnosis
  • A combination of first- and second-degree relatives diagnosed with breast cancer and ovarian cancer (one cancer type per person)
  • A first-degree relative with cancer diagnosed in both breasts (bilateral breast cancer)
  • A combination of two or more first- or second-degree relatives diagnosed with ovarian cancer regardless of age at diagnosis
  • A first- or second-degree relative diagnosed with both breast and ovarian cancer regardless of age at diagnosis
  • Breast cancer diagnosed in a male relative

Women who ARE of Ashkenazi Jewish descent - If any of following apply to your family, you are at an increased risk of a BRCA mutation.

Do you have:

  • Any first-degree relative (mother, daughter, or sister) diagnosed with breast or ovarian cancer
  • Two second-degree relatives on the same side of the family diagnosed with breast or ovarian cancer

Are BRCA gene mutations the only gene mutations associated with breast and/or ovarian cancer?

No. Mutations in several other genes have been associated with breast and/or ovarian cancers. However, the majority of hereditary breast cancers (those with a genetic link) are caused by mutations in BRCA1 and BRCA2.

What research is being done to help individuals with BRCA mutations?

Research studies are being conducted to:

  • Find newer and better ways of detecting, treating, and preventing cancer in people with BRCA mutations
  • Improve genetic counseling methods and outcomes

Information about active clinical trials for individuals with BRCA mutations is available on the National Cancer Institute (NCI) website. The following links will help you search NCI's clinical trials database and retrieve lists of open trials.

In addition, NCI's Cancer Information Service (CIS) provides information about clinical trials and helps with clinical trial searches. Contact NCI's Cancer Information Service (CIS) by phone at 1-800-4-CANCER or the LiveHelp link on NCI's Cancer.gov Web site.

Facing Our Risk of Cancer Empowered (FORCE) has developed a clinical trial and research database designed specifically for people with a high risk of developing hereditary cancers. Click here to search for prevention, treatment, detection, risk, quality-of-life, and registry/observational studies: http://www.facingourrisk.org/information_research/search_hboc_studies.php.