How We Manage People at Higher Risk for Breast Cancer

Breast Cancer Risk Factors

While most breast cancers are not associated with family history, the risk of breast cancer increases significantly when close family members have had breast or certain other cancers. In addition, certain genetic markers have been identified which, if present, may significantly increase your personal risk of breast cancer.

While all women who have had a breast cancer have an increased risk of developing a second breast cancer, some people who have had other cancers may also have a higher risk for developing breast cancer. If you have had radiation treatment to the chest for a cancer in childhood, adolescence or young adulthood, you may be at higher risk for developing breast cancer.

Other women learn they have an increased risk of breast cancer from a finding on a breast biopsy. Most benign results of breast biopsies are NOT associated with an increased risk of breast cancer. Specific pathologic diagnoses – lobular carcinoma-in-situ, atypical ductal and atypical lobular hyperplasias – are associated with an increased breast cancer risk.

Our Services and Approach

If you or your referring doctor are concerned about a higher than average risk for breast cancer, we will work with you to assess that risk and determine whether your risk is higher, and if so, by how much. We also will work with you and your physician to devise the best approach to managing that risk with a program of monitoring and risk reduction through lifestyle modification, medical, and sometimes surgical approaches. We conduct clinical trials exploring novel options for reducing breast cancer risk that you might consider as another option.

Judy Garber, MD, MPH, is director of the Cancer Genetics and Prevention Program.

The Cancer Genetics and Prevention Program at Dana-Farber provides a range of evaluations to help patients determine their risk of cancer, whether through family history, genetic risk, biopsy findings or prior cancer treatment.

The Cancer Genetics and Prevention Program's comprehensive approach includes:

  • Comprehensive risk assessment
  • Genetic counseling
  • Genetic testing for alterations in the BRCA1 and BRCA2 genes, and other breast cancer susceptibility genes, as appropriate
  • Personalized strategies for early detection of breast cancer
  • Provision of proven options to reduce the risk of breast and related cancers
  • Long-term follow-up care to help manage risk
  • Access to clinical trials for reducing the risk of breast and other cancers

Center for BRCA and Related Genes

Mutations in BRCA1, BRCA2, and BRCA-related genes confer increased risk of certain cancers when inherited. These mutations can also be acquired by the cancers themselves. The Center for BRCA and Related Genes provides comprehensive care for patients with inherited and acquired mutations, including clinical therapeutic trials, trials of risk-reducing strategies, and studies of novel early detection markers.

For Individuals Newly Diagnosed with Breast Cancer

Genetic testing is often offered at the time of a cancer diagnosis, since understanding whether or not someone carries an alteration in one of the BRCA or other hereditary breast cancer susceptibility genes can lead to more tailored treatment options or access to clinical trials. It also can help patients to assess their risk for secondary cancers and provide important information for relatives who may be at higher risk of developing the disease.