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Reported March 31, 2003

Family History and Breast Cancer

MANCHESTER, England (Ivanhoe Newswire) -- British researchers say doctors need to do a better job of routinely asking their young breast cancer patients about their family history of breast and/or ovarian cancer. They also say it's important to note the history in their medical records -- a task they say is often overlooked.

Three gene mutations -- BRCA1, BRCA2, and TPS3 -- have been linked to familial and early-onset breast cancer. Lifetime cancer risk for those with these genes is estimated at between 43 percent and 85 percent. Once they get the cancer, those with BRCA1 or BRCA2 mutations are also at increased risk for subsequent tumors, and those with the TPS3 gene carry a higher risk for radiation-induced tumors. Identifying women at high risk for these genetic mutations is, therefore, paramount to effectively treating their disease.

In a research letter in the most recent issue of The Lancet, investigators from St. Mary's Hospital in Manchester detail a study involving 99 young women ages 30 and under who were diagnosed with breast cancer. Investigators questioned all women about their family history of breast and ovarian cancer and tested for the gene mutations. They also looked in their medical records to see if doctors had noted their family history during previous visits.

Investigators found a strong family history in about a third of the women, but in more than half of these cases, the history did not appear in hospital notes. Forty-four percent of the women with strong family histories were found to carry one of the genetic mutations. Just six percent of those without a family history had such genetic anomalies.

Lead author Fiona Lallo, M.D., from St. Mary's Hospital, notes, "Our findings underline the importance of accurate elucidation of a family history from young women with breast cancer for the prediction of mutations ... we recommend that all breast cancer surgical notes include a section on family history, which has to be completed."

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