Investigate your Family Health History
Collecting your family and personal health history is an important step in understanding your personal risk of cancer.
When I was 18 my Nana passed away from breast cancer and after attending her funeral my Mum and I made a family tree of all the women in the family and discovered there were a staggering 13 women who have had breast cancer just on my mums side! – Sam
Talk to your family
It is important to talk to your family to learn about your family health history. Look on both your father’s side and mother’s side of the family.
Document which relatives have had cancer (any type), what type of cancer, date of birth (and age at death is applicable) and how old they were when diagnosed. You can record your Family Health History on the Mapping Form which also includes some useful mapping tips.
For more information on the type of family health history to collect, recording it and tips for talking to your family about health history see Pink Hope’s Kiss and Tell resources.
Features of a hereditary cause for a family history of breast and/or ovarian cancer
Below are a list of factors that can affect your risk of breast and ovarian cancer.
- whether a relative is already known to have had a mutation found on a genetic testthe number of close relatives who have had breast or ovarian cancer,
- a relative with certain types of breast or ovarian cancer (for further information see below)
- a relative with cancers occurring at young ages (e.g. before age 40 years for breast or before age 50 for ovarian cancer)
- relatives with cancer in both breasts
- male relatives with breast cancer
- a relative who has had both breast and ovarian cancer
- an ethnic background from a population where some mutations are more common e.g. Eastern European (Ashkenazi) Jewish ancestry
Certain types of breast or ovarian cancer
Most types of ovarian cancer are of the kind (called high grade serous cancer) where genetic testing is now offered. This is because for about 1 in 7 (15%) women a genetic cause may be identified. So if you have ovarian cancer at any age, have a conversation with your doctor about whether you should be referred to a Familial Cancer Centre.
If you have breast cancer that is ‘triple negative’ (this means where the cancer pathology report shows hormones such as oestrogen or progesterone and another protein called her-2 do not bind to the breast cells) then talk to your doctor about whether a genetic assessment is recommended. This is usually considered if your triple negative cancer was diagnosed before 50 or if you also have a family history of breast or ovarian cancer. There are other situations where a breast cancer diagnosis warrants more discussion with your doctor. Similarly, any man with breast cancer is also advised to discuss a genetic referral with his doctors.
National referral guidelines for health professionals on when to refer to genetic services are listed on the website www.eviq.org.au.
Understanding hereditary cancer
For most women who have a family history of breast or ovarian cancer, there is usually only one person with a breast or ovarian cancer. This type of family history does not automatically put the other family members at a high risk for cancer as those cancers are most likely caused by ‘chance events’.
Some cancers are due to changes (mutations) in combinations of unknown genes, which are still being understood by researchers. Some cancers might be due to a mutation in a hereditary gene where genetic testing is now possible. About 5% to 15% of all cancers are due to a hereditary gene mutation. About 1 in 20 (5%) of women with breast cancer and about 1 in 7 (15%) of women with ovarian cancer, have an inherited mutation in a known high risk cancer gene.
Looking at your family history is a good starting point to assess why a history of breast and/ovarian cancer might have occurred, if genetic testing might be helpful and what this means for your risk of breast or ovarian cancer.
So if you have a family history of cancer we would encourage you to complete our Know Your Risk tool to help you start a conversation with your doctor.
Mum received the news that she was BRCA1 positive the day after she was diagnosed with ovarian cancer. My mum has given her sisters, her daughters and her grandchildren a life-long gift, the information that our family is BRCA1+ so that we can take control of our own health and make informed decisions to reduce our risk of breast and ovarian cancer. – Nicole
Professional healthcare advice
Once you have recorded your family health history, you can complete the Know Your Risk tool and/or see your GP to discuss the findings. If relevant, your GP may refer you to a Family Cancer Clinic where you can see a Genetic Counsellor and have your risk level assessed.
You may also wish to submit questions to the Pink Hope Genetic Counsellor through the Ask Our Genetic Counsellor resource to assist you in researching your family health history.