Hi all, am looking for some advice on family history please.
My family is very small - I’m an only child, my mum was an only child, her mum is an only child.
My mum had breast cancer aged 48, and passed away aged 58.
There are no more close female relations to include in a family history, but my mum’s father had stomach cancer aged 71 and his father had pancreatic cancer aged 69.
I’m wondering whether either of these cancers is significant to why my mum developed breast cancer at a young age and whether this means I may be at increased risk too. I’m a natural worrier anyway, so all this is playing on my mind.
Hi kt83
Welcome to the forums.
Whilst waiting for replies I thought you might like to look at our publication ‘Breast Cancer in Families’ here is a link to it www2.breastcancercare.org.uk/publications/worried-about-breast-cancer/breast-cancer-families-bcc32
We also have a free helpline where the staff can offer practical information as well as emotional support. The free phone number is 0808 800 6000 and the lines are open Monday to Friday 9.00 to 5.00 and Saturday 10.00 to 2.00.
best wishes
June, moderator
Hi kit
one case of breast cancer in a family doesnt usually increase your own risk unless the affected person was very young… Under 40. For somebody over 40 you would normally have 2 breast cancer under age 60 to be at an increased risk
this is the institute of cancer research protocols for early breast screening… http://www.icr.ac.uk/research/team\_leaders/Rahman\_Nazneen/Rahman\_Nazneen\_Protocols/Protocols/18705.pdf
although 48 seems young its not so young in terms of breast cancer and the national screening programme in England is being reduced to age 47, which is presumbly taking this into account.
obviously nobody can predict that you wont get BC but with the family history you describe you shouldnt be at an increased risk but if your at all worried about your risk speak to your Gp or request a referral to genetics and itsobviously important to stay breat aware and if you notice any changes do get them checked out.
Lulu
Hi Lulu,
Thanks for taking the time to answer. Your reply put my mind at rest a little.
I just got worried when I read that pancreatic cancer can sometimes be linked to brca genes as I’m not sure whether mum’s oncologist ever knew that her paternal grandfather died at 69 with PC,and I have no other female relatives at all on that side of the family.
Hi Lulu,
Thanks for taking the time to answer. Your reply put my mind at rest a little.
I just got worried when I read that pancreatic cancer can sometimes be linked to brca genes as I’m not sure whether mum’s oncologist ever knew that her paternal grandfather died at 69 with PC,and I have no other female relatives at all on that side of the family.
Hi Kt
although panc ca is associated with brca2 its not a strong relationship… There is a scoring system sometimes used to assess risk its called the Manchester or Evans score… You add all the points together for those in your family who are affected… So for a female in her 40s with bc would be 6 points and panc ca is 1 point giving a total of 7 points and you nomally need around 16 points to be considered moderate rik and 20 points for it to be considered significant risk… Theres a little bit of info on this page…
http://www.icr.ac.uk/research/team\_leaders/Rahman\_Nazneen/Rahman\_Nazneen\_Protocols/Protocols/22778.pdf
take care
Lulu x
Hi Lulu
Thanks for the info. Do you know if a local recurrence after 7 years would be scored separately from the original diagnosis? Having looked at the FAQs I’m not totally sure?
Also, with the associated cancers, such as panc ca, do you know if age at diagnosis is relevant as it is with breast cancer?
Thanks
Kt
hi Kt
a local recurrence usually means the original cancer has come back again in the same breast so isn’t a new cancer. the onc and breast surgeon who treated your mum should be able to say if they were treating it as a recurrence or a new primary. If it is histologically the same they will normally treat as the original that has come back even if its 20 years later. You can maybe ask them if they think it was a new primary or recurrence. in terms of the Evans score they only really treat cancer in both breasts as two cancers. My unit only treats it as two primaries if the pathologist or surgeon says specifically that its a new primary otherwise it’s treated as a recurrence.
pancreatic cancer is only relevant for determining if have family would fit the criteria for genetic testing really and not for determining if you were of a high enough risk to get early screening… In your own family although its important to have the information it would really have very little bearing on your families risk as breast and ovarian cancer are much more likely… and multiple cases of these would be more likely than a breast and panc ca. However in families with very few women its much harder to get a full picture but they usually look at the information that is available. But as I said if you have any issues why not ask your gp if you can be referred to genetics to discuss it all fully.
Take care
lulu xx
Hi Lulu
I can remember mums oncologist saying it was the same type of cancer as before so I’m pretty sure it was recurrence. I was really shocked to think that something could be dormant like that for so long.
It’s the lack of female relative which concerns me, so may pay a visit to my GP for a chat. When you start looking into family history, either with the GP or genetics people, do you know if they take your word for it or use medical records? Some of our family history I know only through what I’ve been told by others as the people passed away before I was born.
Kt
Kt
at genetics they will make a family tree based on the information you give them and that will be your initial risk assessment. They will then usually look to get confirmations of the cancers in your family, they can send off to the cancer registries or hospitals where your relatives were treated to get this information and also by checking death certificates. occasionally no information is available, eg if the relatives died of something else other than cancer it wouldnt often be on the death cert and the regsitries only started up in the 1950s and they didnt all start at the same time so they may have records for one lady at that time but not another.
if you ask to speak to genetics they can go through the whole thing with you… GPs should be able to find a criteria for referral but even if they are uncertain they would usually err on the side of caution and refer you anyway.
being assessed by genetics wont necessarily mean you will get enhanced screening or get gene tested but if you are moderate or high risk of getting BC then you will be eligible for annual screening between 40 and 50 so it worthwhile getting it checked.
Lulu x