COVER STORY
ASK THE EXPERT
GENETICS AND THE RISK OF BREAST CANCER
W hen you are implications your diagnosis may have for members of your family. You may be considering having genetic testing to see if there’s a hereditary link. The Beacon spoke with Associate Professor Yoland Antill, Medical Oncologist and Cancer Genetics Specialist based in Melbourne, to find out more about genetic testing for hereditary breast cancer. diagnosed with breast cancer, it’s natural to wonder what WHAT ARE SOME OF THE CLUES THAT INDICATE THERE MAY BE A HEREDITARY BREAST CANCER GENE IN MY FAMILY? Any breast cancer diagnosis indicates there may be a genetic relationship, but only a small proportion have an identifiable genetic change. There is a greater likelihood of a genetic cause for breast cancer if the person diagnosed: • is in their early 40s or younger • h as had other breast cancers or related cancers, for example ovarian cancer • h as been diagnosed with a second primary cancer • h as multiple family members on the same side diagnosed with breast cancer or related cancers such as ovarian cancer
HOW DO I ARRANGE A GENETIC TEST AND HOW MUCH DOES IT COST? You can arrange a genetic test through the public and private hospital systems. To be eligible for subsidised genetic testing, covered by Medicare, you need to have a calculated risk of at least 10 per cent. This means a 10 per cent likelihood of there being a genetic change in genes associated with breast cancer risk, with the majority of that risk related to BRCA1 or BRCA2. If your estimated risk is lower than 10 per cent, you will not be eligible for a subsidised test. However, you can pay the full cost yourself if you want to be tested. For self-funded gene tests, the cost can vary from about $350 to about $500, depending on who is providing the test. This is the case whether you are accessing it through the public or private health system. Once a genetic alteration is identified within a family, then all other testing in the family is funded. In some circumstances, you may be able to receive a funded test through a family cancer clinic. Eligibility varies depending on the clinic.
• h as certain pathology types —for example, triple negative breast cancer is more likely to be associated with certain genes, while HER2 positive breast cancer is less likely to be • is a man who has breast cancer. WHAT GENES ARE ASSOCIATED WITH BREAST CANCER? We each have around 25,000 genes. For every gene you have, you have two copies – one inherited from each of your biological parents. In terms of passing on these genes, you pass on only one copy of your genes to your child. The second gene comes from the child’s other biological parent. If a gene has a mutation, it can result in heritable conditions such as an increased risk of cancer. Based on three large population- based studies, the list of single genes likely to impact breast cancer are BRCA1, BRCA2, PALB2, RAD51C, RAD51D, BRIP1, BARD1, p53, CHEK2, ATM, PTEN and CDH1. WHAT IS A GENETIC TEST? Genetic testing is a simple blood test that can show if you carry one of the breast cancer genes. The test needs to be done first on a person in the family who has had a breast cancer diagnosis. If their test result shows that they carry a breast cancer gene, other family members can be tested to see if they also carry it.
December 2022 | Issue 93
Breast Cancer Network Australia
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