BRCA Genes and Family History: Understanding Inherited Breast Cancer Risk
- Youwanush Kongdan
- 2 days ago
- 3 min read
BRCA1 and BRCA2 are genes involved in DNA repair. When a person has a harmful change, often called a pathogenic or likely pathogenic variant, in one of these genes, the risk of breast cancer, ovarian cancer, and certain other cancers may increase significantly. People whose family history suggests inherited cancer risk should speak with a doctor or genetic counselor before deciding whether genetic testing is appropriate. This article explains what BRCA genes are, who may consider genetic counseling, and how risk can be managed.
What are BRCA genes?
BRCA1 and BRCA2 help repair DNA damage and support normal control of cell growth. If one of these genes has a harmful change that disrupts its function, cells may accumulate abnormalities and have a higher chance of developing cancer. A harmful BRCA variant can be inherited from either the mother’s or father’s side of the family.
Why does family history matter?
Many people with breast cancer do not have a family history. However, certain family patterns may suggest inherited risk, such as multiple relatives with breast or ovarian cancer, cancer at a young age, male breast cancer, or a known harmful variant in the family. Collecting accurate family history from both sides of the family is important for risk assessment.
Who should consider genetic counseling or testing?
· People with a close relative diagnosed with breast cancer at a young age, such as before age 50.
· People with multiple relatives with breast cancer or ovarian cancer.
· People with a male relative diagnosed with breast cancer.
· Patients diagnosed with breast cancer at a young age, bilateral breast cancer, or triple-negative breast cancer within an age group that meets testing criteria.
· People with a family member who has a known pathogenic or likely pathogenic variant in BRCA1/BRCA2 or another cancer-risk gene.
Testing criteria and counseling
Genetic testing criteria may vary depending on the guideline used and the patient’s context. Testing should ideally be considered with a doctor or genetic counselor so that the patient understands the meaning of the result, possible implications for family members, and future care options.
What if a harmful BRCA variant is found?
· More intensive surveillance, such as earlier and more frequent screening or adding breast MRI in selected patients.
· Risk-reduction lifestyle measures where appropriate, such as weight control, reducing alcohol, regular physical activity, and avoiding smoking.
· Consideration of risk-reducing medication or surgery in selected cases after detailed counseling.
· Informing and advising relatives who may be at risk so that cascade testing can be considered when appropriate.
Important point
Having a harmful BRCA variant does not mean a person will definitely develop cancer. It means the risk is higher than the general population. Knowing the risk can help patients and families plan screening and prevention in a structured way.
Frequently Asked Questions (FAQ)
Does having a BRCA variant mean I will definitely get cancer?
No. It means the risk is significantly higher than average, but it is not a certainty. Surveillance and risk-reduction planning can improve the chance of early detection or reduce risk in selected situations.
Do I need BRCA testing if I have no family history?
Most people in the general population do not need BRCA testing. However, some patients may meet testing criteria even without a clear family history, such as cancer at a young age or certain tumor types. Discuss this with your doctor.
Can men have a harmful BRCA variant?
Yes. Men can carry and pass on harmful BRCA variants. These variants may also increase the risk of certain cancers in men, including male breast cancer, prostate cancer, and pancreatic cancer.
How is BRCA testing done?
Testing is usually performed using a blood or saliva sample. Genetic counseling before and after testing is important to understand the result and its implications for family members.
If my mother or father has a harmful BRCA variant, what is my chance of inheriting it?
Each child has about a 50% chance of inheriting that harmful variant. A doctor or genetic counselor can advise whether family testing is appropriate.
Clinically reviewed by: Assoc. Prof. Youwanush Kongdan, MD, and the breast surgery team, Namarak Hospital.
Disclaimer: This information is intended for general patient education only. It is not a substitute for personalized medical advice. Diagnosis and treatment decisions should be made by a doctor based on each patient’s individual condition.
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