What Is the BRCA Gene? Understanding Family Breast and Ovarian Cancer

Humans are made up of 20,000 to 25,000 genes — all of which make you who you are. Though small — literally microscopic — there's more to genes than just the Punnett squares you learned in high school biology.

Many traits and abilities run in families, some genetic and some not. Your genes affect everything from your eye color to whether or not you have freckles. Genes are the building blocks of heredity, and they are made up of DNA.

But beyond determining your looks, or if you think cilantro tastes like soap, your genes can impact your health and which diseases are common in your family.

Two of these potentially hereditary diseases are ovarian cancer and breast cancer. While you may be familiar with each of these cancers on their own, you may not be aware of how these two separate cancers can be connected — and how genetics come into play.

With October being Breast Cancer Awareness Month, now is a great time to learn more about how it can be linked to ovarian cancer. Here are the answers to 3 commonly asked questions that can help you understand breast and ovarian cancer, along with the genetic risks.

1. What Is Hereditary Breast and Ovarian Cancer?

You may know multiple people who have cancer. As a prevalent disease, you may even know multiple people in your own family who have or have had a cancer diagnosis. This is a common occurrence, but it can be surprising when more than one relative has the same kind of cancer.

With some cancers, this could be a result of environmental factors or health habits. If a lot of people in your family smoke, for example, you may not be surprised to see more than one case of lung cancer.

But other kinds of cancers can be passed genetically within families. This is the case with both breast and ovarian cancer.

There are two genes currently associated with hereditary breast and ovarian cancer (also called HBOC). They are called BRCA1 and BRCA2. (BRCA stands for BReast CAncer and is pronounced "BRAH-kuh").

"Gene mutations, or harmful changes in the DNA code that make up a gene, cause genes to stop working like they should," explains Dylane Wineland, MS, CGC, Licensed and Certified Genetic Counselor. "Mutations can be hereditary — meaning the change is passed down from a parent when you are born, or acquired — meaning that the change happens in your genes sometime after birth. While acquired mutations are more common causes of cancer, approximately 10 to 15% of breast and ovarian cancers are due to hereditary gene mutations. Genetic testing results may impact cancer treatment decisions as well as screening for other family members. At Chester County Hospital, providers can help guide you through the genetic testing process and can support you at any point in your health journey." 

 

With the BRCA genes, mutation can lead to your cells changing and dividing more quickly, meaning you have a higher risk for cancer

2. When Should I Consider Genetic Testing?

So what do you do if you suspect that your family’s history with cancer could be genetic and therefore hereditary?

First, talk to your provider. If you have a family history of breast or ovarian cancer, you may be curious whether you have mutations in the BRCA1 or BRCA2 genes. By talking to your Chester County Hospital primary care provider, you can determine the best next steps.

Genetic tests are not recommended for just anyone. You should consider genetic testing if multiple individuals on the same side of the family have been diagnosed with ovarian, breast, pancreatic, or high grade prostate cancer.

After talking to your provider, a genetic counselor can help you determine if this test is right for you based on your family history of certain cancers. This is called a "risk evaluation".

Certain tests can pinpoint whether or not you have a mutation in one or both of these genes. These genetic tests can be conducted with either a blood or a saliva sample.

You may be a candidate for BRCA genetic testing if you or someone in your family:

  • Has a known mutation in a cancer risk gene
  • Was diagnosed with breast cancer at age 50 or younger
  • Has more than one breast cancer diagnosis
  • Was diagnosed with ovarian or fallopian tube cancer at any age
  • Was diagnosed with triple negative breast cancer at age 60 or younger
  • Is of Ashkenazi Jewish ancestry and has ovarian, breast, or pancreatic cancer 
  • Was diagnosed with male breast cancer 

Identifying a genetic mutation does not necessarily mean that you will get one of these cancers, but rather that you have an increased risk. This knowledge may create a sense of peace in place of uncertainty. Or it may be overwhelming and scary. All of these feelings and reactions are valid.

You may also decide that is information that you would prefer not to know. Genetic testing is a big decision, but it doesn't need to be a scary one. If you are nervous or on the fence about BRCA genetic testing, talk to your provider, genetic counselor, or cancer team. They can help you understand your available options so you can make the choice that is best for you.

3. How Can Chester County Hospital and Penn Medicine Support Me?

While cancer is a scary possibility or diagnosis, you are not alone. The resources and support offered by the partnership between Chester County Hospital and Penn Medicine are personal,  cutting edge, and here for you.

Chester County Hospital's Cancer Risk Evaluation Program

 The Cancer Risk Evaluation Program (CREP) at The Abramson Cancer Center at Chester County Hospital is designed to help those with a family history of gastrointestinal, breast, and ovarian cancer.

CREP offers genetic counseling to help you understand your family cancer history and make informed decisions related to your own medical future.

Penn Medicine’s Basser Center for BRCA

The Basser Center at Penn Medicine is the first center of its kind. Dedicated to the research, treatment, and prevention of BRCA-related cancers, their approach is transforming the future of cancer knowledge.

At the Basser Center, you can learn more about BRCA, meet with a genetic counselor, and schedule an appointment for genetic testing.

Knowledge Is Power — But So Is Choice

Attending an appointment for genetic counseling does not mean that you have to undergo genetic testing. For some, knowing their increased risk for a breast or ovarian cancer diagnosis may bring them some peace of mind. For others, this kind of testing may do the opposite.

There is no right answer, or any one way to feel. Your Chester County Hospital provider can help you understand all of your available options, empowering you to make the decision that works for you.

To discuss your family's medical history with cancer, request a callback from a provider at the Abramson Cancer Center, or schedule an appointment with your Chester County Primary care provider.

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