Dear doctor, both my mother and sister have had breast cancer and I'm terrified I'll get it too. What can I do?

Both my mother and very recently my sister have had breast cancer and I'm absolutely terrified that I will get it too. I don't want to sit around and wait until I find a lump in my breast, what can I do?

The lifetime risk of a woman developing breast cancer is 1 in 8. Most of these cancers are not inherited.

There are a very small number of breast cancers which may be caused by inheritance of a known faulty gene (BRCA1, BRCA2 or TP53). These tumour suppressor genes normally produce proteins that can help repair damaged DNA and therefore play a vital role in stabilising each cell's genetic material. When either of these genes is mutated, or altered, such that its protein product is not made or does not function correctly, DNA damage may not be repaired properly. As a result, cells are more likely to develop additional genetic alterations that can lead to cancer.

Testing for these genes can be carried out on blood or saliva samples but should only be considered after a full family history risk assessment is carried out by a healthcare professional. Your mother or sister may already be in the process of having their genes tested.

The family history assessment can be carried out by a Breast or Genetics Specialist or within a specialist family history clinic. They will then be able to determine whether you fall into a general population, moderate or high risk category.

If you fall into a moderate or high risk category, you may be offered enhanced screening, genetic counselling and genetic testing. Treatment to reduce the risk can be in the form of medication (chemoprophylaxis) or surgery.

Find out more about Mr Avi Agrawal, Consultant Breast Surgeon practising at Spire Portsmouth Hospital.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.