Inherited cancers: breast and ovarian cancer

Most people with breast or ovarian cancer do not have a gene mutation running in their family. If you are worried about cancer in your family, talk to your GP. If needed, they will refer you to a genetics specialist. 

A small number of people inherit gene mutations that cause a higher risk of breast or ovarian cancer. The most common are BRCA1 and BRCA2 gene mutations.

Women with an inherited BRCA1 or BRCA2 mutation have a higher risk of developing breast or ovarian cancer during their lifetime. 

Men can also inherit a BRCA1 or BRCA2 mutation. But they are less likely to develop cancer because of it. They may have a higher than average risk of prostate or breast cancer. 

For men and women, a mutation may also cause a slightly higher than average risk of some other types of cancer.

If you have a higher risk of breast and ovarian cancer, there are ways to reduce it. This may include: 

  • breast screening tests 
  • being aware of the symptoms of breast and ovarian cancer
  • risk-reducing treatments 
  • lifestyle changes.

About breast and ovarian cancer

Breast cancer is one of the most common cancers in the UK. It affects 1 in 8 women (around 13%) and 1 in 870 men (around 1%) during their lifetime. Ovarian cancer is less common. 1 in 52 women (around 2%) will be diagnosed with ovarian cancer during their lifetime. Many people have someone in their family who is affected by one of these cancers. Only a small number of cases are clearly linked to inherited cancer genes.


Understanding breast and ovarian cancer in your family

An inherited gene mutation that increases the risk of breast and ovarian cancer is more likely if there is a pattern of cancer in your family. These are examples of patterns:

  • One of your first-degree relatives was diagnosed with breast cancer before the age of 40. First-degree relatives are your parents, brothers, sisters and children.
  • Several family members have been diagnosed with breast cancer or ovarian cancer.
  • A male relative was diagnosed with breast cancer.
  • A relative had breast cancer in both breasts (bilateral breast cancer).
  • You have a family history of cancer and you are from an Eastern European or Ashkenazi Jewish (Eastern European Jewish) background.

If you are worried about the pattern of cancer in your family, talk to your GP. If needed, they will refer you to a genetics specialist.


Inherited breast and ovarian cancer genes

Inherited mutations in several different genes can cause an increased risk of breast and ovarian cancer.

BRCA1 and BRCA2

The genes most often linked to breast and ovarian cancer are called BRCA1 and BRCA2. BRCA is short for BReast CAncer.

Women with an inherited BRCA1 or BRCA2 gene mutation have a higher risk of developing breast or ovarian cancer during their lifetime.

Men can also inherit a BRCA1 or BRCA2 mutation, but they are less likely to develop cancer because of it. They may have a higher than average risk of prostate cancer or breast cancer.

For both men and women, a mutation may also cause a slightly higher than average risk of some other types of cancer.

PALB2, ATM and CHEK2

Women with an inherited mutation in the PALB2, ATM or CHEK2 genes have a moderate risk of developing breast cancer during their lifetime. Women who also have many relatives or younger relatives with breast cancer have a higher risk of developing it. They may also have a slightly higher than average risk of some other types of cancer.

One type of ATM mutation, called c.7271T>G, seems to cause a high risk of breast cancer in women.

Men can also inherit mutations in these genes, but they are less likely to develop cancer because of them.

BRIP1, RAD51C and RAD51D

Women with an inherited mutation in the BRIP1, RAD51C or RAD51D genes have a moderate risk of developing ovarian cancer during their lifetime.

It is not known if it causes a higher risk of other cancer types in women or in men.

Other inherited breast cancer genes

Other rare inherited conditions that can increase breast cancer risk in women include:

  • Cowden syndrome
  • hereditary diffuse gastric cancer
  • Li-Fraumeni syndrome
  • Peutz Jeghers syndrome
  • neurofibromatosis type 1.

These conditions are caused by inherited mutations in genes, including the TP53, CDH1, PTEN and SKT11 genes. There are also likely to be other gene mutations that we currently do not know about. This means some families have a clear pattern of breast or ovarian cancer, but genetic tests do not find a mutation.

Genetic Alliance UK offers information and support about rare inherited conditions.


Managing a higher risk of breast and ovarian cancer

If your family history or genetic test shows you have a higher risk of breast and ovarian cancer, there are ways to reduce that risk. This may include:

  • breast screening tests
  • being aware of the symptoms of breast and ovarian cancer
  • risk-reducing treatments
  • lifestyle changes.


Breast screening

Regular breast screening cannot prevent breast cancer. But it can often help find it at an early stage, when many breast cancers can be cured. Screening is done using breast x-rays (mammograms) or MRI scans.

Your genetics specialist will explain if you need these tests, when you should start having them and how often.

Once I had understood my personal risk, I decided against surgery and now have regular mammograms to manage the breast cancer risk.

Daloni


Ovarian screening

So far in the UK, screening is not offered for ovarian cancer. This is because current screening tests cannot find ovarian cancer early enough to make it more treatable.

Researchers are still trying to find the most effective way to screen for ovarian cancer. Some women are offered screening as part of a clinical trial. Your doctor can explain if this is available and the possible risks and benefits of taking part in a clinical trial.


Risk-reducing treatments

Women with a high risk of breast and ovarian cancer may be offered the following treatments:

  • Surgery to remove both breasts – This reduces the risk of breast cancer by about 95%. We have more information about risk-reducing breast surgery.
  • Surgery to remove the ovaries and fallopian tubes – This reduces the risk of cancer in and near the ovary by over 95%. Women who decide to have this surgery will start the menopause if they have not already. They will no longer be able to get pregnant.
  • Drug treatment – Taking an anti-oestrogen tablet (such as tamoxifen, anastrozole or raloxifene) every day for 5 years can reduce the risk of breast cancer. The drugs used are not suitable for everyone and can cause side effects.

It is important to talk to your doctor about the side effects, risks and benefits of any treatment you are offered. If you have questions about fertility, you can ask to see a fertility specialist for more advice. If a treatment causes an early menopause, there are treatments that can help manage any symptoms.

Knowing about the BRAC2 gene mutation was hugely important in making decision about treatment. Having the double mastectomy was the right choice for me in the end.

Katy


Know your body

Cancer can often be successfully treated, especially when it is found at an early stage. Knowing what is normal for your body means you are more likely to recognise any changes that could be a sign of cancer. This means if you do develop a cancer, it can be treated as early as possible.

I noticed I had a lump in my breast. But I always had very lumpy breasts during my periods. Then in the shower, I noticed my nipple had turned in.

Jodie


Healthy lifestyle