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What’s your risk?
“My mum has breast cancer, would I get it also?” I’ve had this question and many similar ones posed to me at our breast clinic, Pink Hibiscus. The fear, concern and anxiety that echoes from this question is truly a remarkable one coming from women of all ages.
Patients are very eager to know about their risk and what they should do next to screen for breast cancer. Many are fearful that it is simply a matter of time before it’s their turn and become quite anxious wanting to get assessed.
The calculated risk isn’t the same fixed value for every woman—it isn’t a “cookie-cutter” method. Knowing this risk and what to do comes after a detailed and thorough assessment of the patient’s family history at a specialised breast unit geared to managing a family history/genetics clinic.
Internationally acclaimed breast clinics in the UK and USA are able to offer women this risk assessment, and many of our women in Trinidad are able to obtain this service at Pink Hibiscus.
Having a family history of breast cancer does not necessarily mean that a woman will develop breast cancer or that her risk is increased. By careful and meticulous assessment of this group of women at our clinic we are able to evaluate if the patient’s risk is the same as the average woman with no family history or if the risk is elevated.
In this way, it allows us to tailor the patient’s screening if necessary and knowing whether more needs to be done for breast screening—for example whether additional tests like MRI of the breast needs to be included or if screening starts before 40.
Being able to determine those high-risk patients for BRCA 1 or BRCA 2 mutation can also be evaluated and the genetic testing performed. Not all women with a family history will be suitable candidates for this testing. The assessment at the clinic can help in personalising the patient’s management and providing the best possible plan for screening.
Many women who come to our clinic believe that if they have no family history of breast cancer that they are not likely to develop it. However, the statistics show that most breast cancer cases actually occur in women with no family history and it is due to a random genetic mutation as we age and not from inheritance of an abnormal breast cancer gene.
It is calculated that approximately 85 per cent of breast cancers account for these cases, with the remaining 15 per cent with having a relative with breast cancer. It is also reported that only five to ten per cent will be linked to an inherited gene mutation from either the maternal or paternal side.
Knowing your risk once you’ve got a family history is very important. The key in fighting breast cancer is early detection for better prognosis and quality of life. So if you’ve got a family history of breast cancer, getting assessed in a genetics clinic at a specialist breast unit is crucial to knowing what screening tools are needed for you.
• Dr Shashta Sawh, Breast Physician, 5 Adam Smith Square, Woodbrook, Port-of-Spain, Contact: 627-1010, Website: www.pinkhibiscustt.com.