Hereditary Breast and Ovarian Cancer (HBOC) Syndrome (BRCA1/2)

What is HBOC?

HBOC is an inherited condition that causes people to have an increased risk to develop a few different types of cancers at earlier ages than people typically develop cancer. HBOC accounts for approximately 5-10 percent of breast and ovarian cancers diagnosed every year. The majority of HBOC is due to a mutation in either the BRCA1 or BRCA2 genes; however, not all families with a history of HBOC-associated cancers will have a mutation in these genes.

What cancer risks are associated with HBOC?

Individuals with a mutation in BRCA1 or BRCA2 have an increased risk to develop a few different types of cancers. Female carriers have a 50-85 percent risk of developing breast cancer and a 15-45 percent risk of developing ovarian cancer in their lifetime. Female carriers who have already had breast cancer also have a 50-60 percent chance they will develop another primary breast cancer. Male carriers have an increased risk of developing male breast cancer and prostate cancer. Other cancers, including pancreatic cancer, melanoma and others may also occur more often in these individuals. 

What is the benefit of knowing I have a mutation in BRCA1 or BRCA2?

If you have a mutation in BRCA1 or BRCA2, Parkview’s genetic counselors will discuss recommendations for additional screening and/or preventative strategies that can greatly decrease your risk for cancer.  These recommendations include:

  • Increased breast cancer screenings using both mammograms and breast MRI on a more frequent basis starting as early as 25 years of age
  • Preventative double mastectomies to greatly reduce the risk for breast cancer
  • Consideration of certain medications such as tamoxifen to reduce breast cancer risk
  • Surgery to remove the ovaries and fallopian tubes between the ages of 35 and 40 or when childbearing is complete (ovarian cancer screening currently available may not effectively detect ovarian cancer)

Who should consider BRCA1/2 genetic testing for HBOC?

We recommend genetic counseling to evaluate your specific risk and to discuss the possibility of genetic testing.  Genetic counseling is appropriate if you were diagnosed with:

  • Breast cancer at or before 50 years of age
  • Breast cancer at any age and have two or more family members with breast cancer on the same side of the family
  • Triple negative breast cancer (ER-, PR-, HER2-)
  • Two breast cancer primaries (meaning you have two cancer diagnoses, which both originated in the breasts)
  • Ovarian/fallopian tube/primary peritoneal cancer
  • Male breast cancer

Consider genetic counseling if you have not been diagnosed with cancer, but:

  • Have two or more relatives with breast cancer on the same side of the family
  • Have a family history of ovarian cancer
  • Have a known mutation in BRCA1, BRCA2 or PTEN in your family
  • Are of Ashkenazi Jewish ancestry
  • Have a family history of male breast cancer

If I am found to have a mutation in BRCA1/2, what does that mean for my family?

Mutations in BRCA1/2 are passed down in families. People who have a mutation likely inherited that mutation from one of their parents. If you have a mutation in BRCA1/2, your children have a 50 percent chance of having the same mutation. In addition, your siblings also have a 50 percent chance of having this mutation. 

We recommend that your family members meet with a genetic counselor to discuss possible testing.  People within the same family will often react differently to this kind of information, and whether family members choose to pursue testing is a personal choice. As there is no risk for cancer to occur in children who have a BRCA1/2 mutation, we do not test people younger than 18 years of age for mutations in BRCA1/2. 

To schedule an appointment with a genetic counselor, please call Parkview Genetic Counseling at (260) 266-9225. For more information, please read our frequently asked questions.