With Mayo Clinic genetic counselor Carrie A. Zabel, M.S., C.G.C.

Being that October is National Breast Cancer Awareness month, I decided to focus this week on assessing hereditary risk for breast cancer. Many people have a personal or family history of breast cancer and wonder how this will affect their future cancer risk or that of their family members. One of the keys to assessing your breast cancer risk is knowing your family history.

It's important to know that most breast cancer is not caused by a single gene predisposition, such as BRCA1 or BRCA2 (two genes widely publicized by the media). The majority of breast cancer is caused by the interaction of both genetic susceptibility factors and environmental factors; we call this multifactorial inheritance. There is no genetic testing available for families with multifactorial breast cancer yet, as the genes with a mild or moderate impact are not yet known, but research is focused on better understanding these families.

In the 10 percent of breast cancer which is thought to be caused by a single gene predisposition, or a strong genetic factor, red flags in an individual's personal or family medical history include:

• Early-onset breast cancer (before age 50)
• Ovarian cancer at any age
• Cancer in 2 or more close relatives
• Multiple or bilateral primary tumors
• Cancer appears to affect every generation

If you are concerned about your personal or medical family history, you can consider being further evaluated and educated by a genetic counselor. To locate one in your area, go to the National Society of Genetic Counselors Web site (see below) and click on the "Find a Counselor" link.

A genetic counselor will discuss your risk for breast cancer and your chance to have an underlying genetic alteration, such as a BRCA1 or BRCA2 mutation. They will also discuss the pros and cons of genetic testing, and what that means to you personally, as well as help facilitate testing, if you should desire.

Please share your experiences in this area.

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