Carrying a BRCA mutation significantly increases your risk of developing breast cancer. Both high risk men and women, should regularly check their breasts for changes. Breast Cancer Care has resources on checking your breasts and what to expect at screening appointments on their website.
From the age of 30, women with BRCA mutations or high risk women who have a strong family history of breast cancer, will be offered an annual MRI. A MRI is a medical imaging test that does not involve radiation and acts as a means of screening your breasts and diagnosing cancer.
A mammogram is a breast x-ray and will be offered to women with a BRCA mutation or those who are at increased risk due to family history usually once a year from the age of 40. Mammograms are not often used before the age of 40 as younger women’s breast tissue can be dense which can make the x-ray image less clear so changes can be harder to identify.
It is important to note that both MRI and mammography will not prevent cancer but may detect it early.
If on MRI or mammography there is any concern, you will be offered a biopsy. With any screening process there is the risk of false positive results. This means that the biopsy result does not show the presence of a cancer.
A number of women with BRCA1/2 mutations decide to undergo bilateral risk-reducing mastectomies (removal of both breasts). This is undertaken by a specialist breast surgeon following extensive counselling. This operation removes as much breast tissue as possible in order to reduce the risk of developing breast cancer. The residual risk of breast cancer following the operation is around 5% to 10%.
Following surgery, you will be offered reconstruction. There are many different types of reconstruction – some use implants or expanders and others your own body tissue. Discuss all the options with your surgical team and other women who have been through the same experiences. There are a number of services available to help women when they’re faced with making such a decision including Breast Cancer Care’s nurse-led information service and the Someone Like Me Service.
If you have not had a diagnosis of cancer and are not considering risk-reducing surgery, you may be offered Chemoprevention. Chemoprevention is the use of medication to lower the risk or prevent cancer in healthy people. Studies have shown that taking a course of Tamoxifen or Raloxifene for 5 years can lower your breast cancer risk.
As with all medications, there are side effects that you will have to consider and discuss in depth with your medical team.
Male breast cancer
Men who inherit a BRCA2 mutation have an increased risk of developing male breast cancer. Due to the strong association between male breast cancer and BRCA2 mutations, first degree relatives (siblings, parents, children) of a man diagnosed with breast cancer may want to ask their GP for a referral to their local genetics centre to discuss BRCA testing. Breast Cancer Care has further information about breast cancer in men and what to look out for.
The lifetime risk of developing breast cancer is approximately 1% with the BRCA1 gene mutation and 7% with a BRCA2 gene mutation. The majority of male breast cancers happen in men who have no family history and no inherited gene abnormality.