A relatively small study found that one third of people who were tested for abnormal breast cancer genes (BRCA1 or BRCA2) supported the same testing for their children.
Most inherited cases of breast cancer are associated with mutations in two genes: BRCA1 (BReast CAncer gene one) and BRCA2 (BReast CAncer gene two). Women with a BRCA1 or BRCA2 genetic mutation have up to a 72% risk of developing breast cancer by age 80. Their risk of ovarian cancer also is higher than average.
Women with an abnormal breast cancer gene have a number of options to reduce the risk of developing breast cancer, as well as ways to detect any cancer that develops earlier, when it's most treatable, including:
- a more aggressive screening plan, starting at an earlier age
- hormonal therapy, to block the effect of estrogen on breast tissue
- removing the healthy breasts (called prophylactic mastectomy)
Some women also may consider having their healthy ovaries removed because of the increase in ovarian cancer risk. Removing the ovaries also dramatically lowers estrogen levels, and lower estrogen levels can reduce the risk of hormone-receptor-positive breast cancer..
These prevention options are for adults. There are no prevention recommendations for children who may have an abnormal breast cancer gene. Because there aren't any options, it seems that BRCA1/BRCA2 testing would only lead to stress and worry in the young person who tests positive and in the parents.
In this study, 246 people who were parents of a child 18 years old or younger were tested for an abnormal breast cancer gene. Each person was asked if genetic testing for children made sense in a yes-or-no question. The participants were then asked the question again as an open-ended question and asked to explain their opinions.
When answering the yes-or-no question, 37% of parents said they supported genetic testing for kids, 55% were opposed, and 8% were unsure.
When answering the open-ended question and explaining their opinions, 47% of parents said they supported genetic testing for kids in some or all circumstances. This means that some of the parents who were unsure or opposed to genetic testing for kids changed their opinion when given the chance to explain their thoughts.
Parents who opposed genetic testing for children gave these reasons for not supporting the testing:
- the results could create unnecessary fear and worry in their children
- their children didn't have the capacity to understand the implications of a positive result
- there are no recommended prevention options for children who have an abnormal breast cancer gene
This study adds to evidence showing that people tend to overestimate breast cancer risk in girls and young women. Overestimating risk may explain why some of the parents felt genetic testing for their children made sense.
While testing an adolescent girl for an abnormal breast cancer gene may not make sense, helping her live a healthy lifestyle that can reduce her breast cancer risk makes a lot of sense. A healthy lifestyle includes:
- maintaining a healthy weight
- exercising regularly
- avoiding alcohol
- not smoking
If you're the parent of a teen or tween girl, make time to talk to your daughter about her breasts, normal breast development, and the facts about breast cancer risk in mothers and daughters. During your daughter's regular check-ups, you may want to ask her doctor about breast health and make sure your daughter is part of the conversation. This is especially important if you or someone your daughter knows has been diagnosed with breast cancer. If you've been diagnosed, it might help to have your doctor talk to your daughter about your diagnosis and what it means and doesn't mean for her. Talking to your daughter about breast health and diet and lifestyle choices she can make is the best way to keep your daughter's risk of breast cancer as low as it can be.
Breastcancer.org Chief Medical Officer Dr. Marisa Weiss and her daughter, Isabel, have written the book Taking Care of Your "Girls:" A Breast Health Guide for Girls, Teens, and In-Betweens. They talk candidly about breast development and breast health -- separating myths from facts and detailing steps everyone can take to improve breast health and reduce breast cancer risk over a lifetime.
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Editor’s Note: This article was updated on Jan. 24, 2019, with updated information on cancer risk associated with BRCA mutations.