Hereditary Breast Cancer

At the Weiser Family Center for Breast Cancer all new breast cancer patients are offered a screening questionnaire to evaluate whether genetic testing is recommended. Our expert team of internationally renowned clinicians offers comprehensive, personalized treatment, from early detection and treatment to survivorship support.

If you're a patient interested in making an appointment, please call 734-647-8902. 

Healthcare providers looking to refer a patient, please contact M-LINE: 800-962-3555.

For those with questions, please contact our Cancer AnswerLine at 800-865-1125.

BRCA1 and BRCA2

• BRCA1: Mutations in the BRCA1 gene can significantly increase the breast cancer risk by up to 72% by age 80. This mutation also raises the risk of ovarian and other cancers.
• BRCA2: Mutations in BRCA2 similarly increase the breast cancer risk by up to 69% by age 80 and elevate the chances of developing ovarian, prostate, and pancreatic cancers.

Other Genetic Mutations

• TP53: Associated with Li-Fraumeni syndrome, this mutation increases the risk of several cancers, including breast cancer.
• PTEN: Involved in Cowden syndrome, which increases the risk of breast and other cancers.
• PALB2: Mutations in this gene can double the risk of breast cancer.
• CHEK2: This gene mutation moderately increases the risk of breast cancer.
• ATM: Mutations in the ATM gene are associated with an increased breast cancer risk.
• CDH1: Mutations in the CDH1 gene are associated with an increased risk for invasive lobular cancer and stomach cancer.

• Family History: A strong family history of breast or ovarian cancer can indicate a possible hereditary risk.
• Early-Onset Breast Cancer: Breast cancer diagnosed before age 50 is more likely to be hereditary.
• Multiple Cancers: Individuals with multiple primary cancers, such as breast and ovarian cancer, may have a genetic predisposition.
• Male Breast Cancer: Men diagnosed with breast cancer have a higher likelihood of carrying genetic mutations like BRCA1 or BRCA2.

The U-M Rogel Cancer Center's Breast and Ovarian Cancer Risk Evaluation Clinic provides testing and counseling services for Michigan Medicine patients and members of their families that have a history of breast or ovarian cancer.

• Genetic Counseling: A genetic counselor evaluates family history and discusses the pros and cons of genetic testing.
• Genetic Testing: Testing for BRCA1, BRCA2, and other mutations can inform risk levels and guide preventive measures.

Interpreting Results

• Positive Result: Indicates a higher risk of breast cancer. Affects not just the individual but also has implications for relatives.
• Negative Result: Does not completely rule out the risk but indicates no known high-risk mutations.
• Variants of Uncertain Significance (VUS): Mutations with unclear impacts on cancer risk require regular updates and possible further testing.

If the results of genetic testing is positive, your doctor will work with you to develop a plan that may involve one or more of the following options.

Increased Surveillance to Detect Breast Cancer

• Women with BRCA Mutations:
  • Begin MRI and mammography screenings at age 25-30.
  • Consider twice yearly clinical breast exams.
• Men with BRCA2 Mutations:
  • Periodic clinical breast exams.
  • Mammography or MRI if there is a personal history of breast cancer.

Preventive Surgeries

• Prophylactic Mastectomy: Preventive removal of breasts can significantly reduce breast cancer risk.
• Prophylactic Oophorectomy: Removal of ovaries reduces risk of both ovarian and breast cancer, especially in BRCA mutation carriers.

Risk Reducing Medication

Drugs like tamoxifen or raloxifene can lower the risk of developing breast cancer.

Lifestyle Modifications

• Healthy Diet and Exercise: Maintaining a healthy lifestyle may help reduce cancer risk.
• Avoiding Known Carcinogens: Such as tobacco and excessive alcohol.

The following considerations are made when a patient diagnosed with breast cancer learns through testing their cancer is hereditary:

• Personalized Medicine: Genetic information can influence treatment decisions, including surgical options and targeted therapies.
• Targeted Therapies - PARP Inhibitors: Drugs like olaparib (Lynparza) and talazoparib (Talzenna) are often used for BRCA-mutated cancers.
• Family Implications: Relatives may need genetic counseling and testing due to shared genetic risks.