Breast Cancer Awareness Month - MyriadMyRisk

October is Breast Cancer Awareness Month

Stage IIIB Breast Cancer

Breast Cancer Stage IIIB

Breast Cancer Quick Facts


  • Annual cases: 246,6601
  • Median age at diagnosis: 621
  • Overall 5-year relative survival rate: 89.7%1
  • Lifetime risk in general population: 12.3%1
  • Risk with an affected 1st degree relative: 1.8-2.1x the general population risk2,3

Overview

The breast is mainly made up of three components: lobules, ducts, and fatty tissue. Breast cancers that arise from the epithelial cells lining these ducts and lobules are called carcinomas and account for the majority of all breast cancer cases.

Carcinomas of the breast can be found to have either invaded into surrounding tissues (invasive or infiltrating) or not (in situ). In situ carcinomas, such as ductal carcinoma in situ (DCIS), are treated very differently and much less aggressively than its invasive counterpart. The most common breast cancer is the invasive ductal carcinoma and is the focus of this document.

While the primary focus for breast cancer is on women, men can get breast cancer as well. In 2016, it is estimated that ~2,600 new cases of invasive breast cancer will be diagnosed in men in the United States.4

Hereditary Facts

Patients with a personal and/or family history of breast cancer may be at risk for hereditary cancer

Clinical research has validated that multiple genes are associated with hereditary breast cancer. Individuals with mutations in these genes have significantly increased risks of breast cancer including an up to 51% risk of breast cancer before the age of 505, up to 87% lifetime risk of breast cancer6, and up to 64% risk of a second primary breast cancer.7

Associated Myriad myRisk® Genes

Associated Myriad myRisk® Genes

Hereditary Breast Cancer Risks

Hereditary Breast Cancer Risks


Screening/Prevention

Screening for WOMEN with a BRCA1 or BRCA2 gene mutation8

  • Monthly breast self-examinations, beginning at age 18
  • Clinical breast examinations performed twice a year by a doctor or nurse, beginning between the ages of 25 to 30
  • Yearly magnetic resonance imaging (MRI) scans of both breasts, beginning at age 25
  • Yearly MRI alternating every 6 months with mammograms, beginning at age 30
  • Pelvic examination, trans-vaginal ultrasound with color doppler, and CA-125 blood test every 6 months, beginning at age 30
  • Consideration for risk reducing salpingo-oophorectomy (removal of ovaries and fallopian tubes) by age 40 or once child-bearing is complete (screening for ovarian cancer is not yet able to identify the majority of early cancers)

Screening for MEN with a BRCA1 or BRCA2 gene mutation8

  • Monthly breast self-examinations, beginning around age 30
  • Yearly clinical breast examinations, beginning around age 30
  • Baseline mammogram at age 35 for men with a BRCA2 gene mutation
  • Yearly prostate cancer screening with digital rectal exam and PSA blood test, beginning at age 40. Current USPSTF guidelines for men that recommend reducing the use of PSA screening do not apply to men at increased risk due to a BRCA1 or BRCA2 gene mutation.”

Know the red flags associated with hereditary cancer:

Red Flags for Hereditary Cancer
An individual with a personal or family history of any ONE of the following:

MULTIPLE CANCERS

A combination of cancers on the same side of the family

  • 2 or more: breast / ovarian / prostate / pancreatic cancer
  • 2 or more: colorectal / endometrial / ovarian / gastric / pancreatic / other cancers (i.e. ureter/renal pelvis, biliary tract, small bowel, brain, sebaceous adenomas)
  • 2 or more: melanoma / pancreatic

YOUNG CANCERS

Any 1 of the following cancers at age 50 or younger

  • Breast cancer
  • Colorectal cancer
  • Endometrial cancer

RARE CANCERS

Any 1 of these rare presentations at any age

  • Ovarian cancer
  • Breast: male breast cancer or triple negative breast cancer
  • Colorectal cancer with abnormal MSI/IHC, MSI associated histology††
  • Endometrial cancer with abnormal MSI/IHC
  • 10 or more gastrointestinal polyps*
Certain ancestries may have greater risk for hereditary cancer syndromes (e.g., Ashkenazi Jewish ancestry)


Assessment criteria based on medical society guidelines. For these individual medical society guidelines, go to www.MyriadPro.com/guidelines.
Family members include first-, second-, and third-degree blood relatives on both your mother and father’s sides.

*Adenomatous type.
††Presence of tumor infiltrating lymphocytes, Crohn’s-like lymphocytic reaction, mucinous/signet-ring differentiation, or medullary growth pattern.

Know your patients’ hereditary cancer risks and medical management options with the Myriad myRisk® Hereditary Cancer Panel


References

  1. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/statfacts/html/breast.html. Accessed 9/2/2016.
  2. Pharoah PD, Day NE, Duffy S, Easton DF, Ponder BA. Family history and the risk of breast cancer: a systematic review and meta-analysis. Int J Cancer. 1997 May 29;71(5):800-9. PubMed PMID: 9180149
  3. Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet. 2001 Oct 27;358(9291):1389- 99. Review. PubMed PMID: 11705483
  4. American Cancer Society. What are the key statistics about breast cancer in men?
    http://www.cancer.org/cancer/breastcancerinmen/detailedguide/breast-cancer-in-men-key-statistics.
  5. Easton DF, et al. Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Am J Hum Genet. 1995 56:265-71. PMID: 7825587
  6. Ford D, et al. Risks of cancer in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Lancet. 1994 343:692-5. PMID: 7907678
  7. Jardines L, et al. Breast Cancer Overview: Risk Factors, Screening, Genetic Testing, and Prevention. Cancer Network, Oncology June 2015
  8. ASCO’s Cancer.Net Hereditary Breast and Ovarian Cancer, http://www.cancer.net/cancer-types/hereditary-breast-and-ovarian-cancer

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