Genes For Breast Cancer? Look To Dad

(CBS/AP)  A deadly gene's path can hide in a family tree when a woman has few aunts and older sisters, making it appear that her breast cancer struck out of nowhere when it really came from Dad.

A new study suggests thousands of young women with breast cancer — an estimated 8,000 a year in the U.S. — aren't offered testing to identify faulty genes and clarify their medical decisions.

Guidelines used by insurance companies to decide coverage for genetic testing should change to reflect the findings, said study co-author Dr. Jeffrey Weitzel of City of Hope Cancer Center in Duarte, Calif. Testing can cost more than $3,000.

"Interestingly, it's about Dad," Weitzel said. Half of genetic breast cancers are inherited from a woman's father, not her mother. But unless Dad has female relatives with breast cancer, the faulty gene may have been passed down silently, without causing cancer. (Men can get genetic breast cancer, too, but it's not common.)

Weitzel said doctors often overlook the genetic risk from the father's side of the family.

"Knowing about your genetic history, knowing if you carry these genes is vitally important," The Early Show medical correspondent Dr. Emily Senay said, "because it will dictate how doctors go about treating you and how they go about monitoring you and even preventing the development of breast and ovarian cancer. This is critical information."

The study, appearing in Wednesday's Journal of the American Medical Association, looked at the genetic test results from 306 women diagnosed with breast cancer before age 50.

None of the cancer patients in the study had a family history of breast or ovarian cancer.

Among the women with plenty of female relatives, 5.2 percent had BRCA gene mutations ("BR" for breast, "CA" for cancer"). But among those with few sisters and aunts older than 45 (when breast cancer would be likely to appear), almost 14 percent had mutations of the genes BRCA1 or BRCA2. That suggests that these cancer patients were unaware of their genetic mutations because there were so few women in the family to signal a cancer risk.

The researchers defined few female relatives as fewer than two on either the father's or mother's side of the family.

Women who were adopted and don't know their family medical history should be aware of the findings, Weitzel said. Women whose female relatives died young before breast cancer had time to show up also are affected.

When such a woman gets breast cancer before age 50, she should get a genetic test, said Dr. Noah Kauff, a cancer geneticist at Memorial Sloan-Kettering Cancer Center in New York. That would help her decide whether to have the unaffected breast or her ovaries removed to prevent more cancer. Kauff was not involved in the research, but wrote an accompanying editorial.

"The study allows physicians and patients to make an argument to insurance carriers that, although there's not a family history of breast cancer, it's still reasonable to test and it should be a covered benefit," Kauff said.

Genetic testing helps a woman choose her next medical steps. A woman with breast cancer who has a BRCA gene mutation has a four times greater risk of developing cancer in the other breast and a 10 times greater risk of ovarian cancer than does a woman with breast cancer who has no BRCA gene mutation.

"It increases the risk so much, doctors will recommend that women undergo a preventive or prophylactic mastectomy. They may even recommend ovary removal to prevent the development of cancer," Dr. Senay said. "So yes, it has a real impact on the decisions made about the woman's health" — such as the efficacy of alternative treatements, like drug therapy or monitoring with annual MRI tests.

Testing the genes of more women would cost more money, but Weitzel said that won't add significantly to health care costs and will prevent cancer in some of the women.

The study also showed that three commonly used predictive models don't accurately estimate the genetic breast cancer risk for women without a family history of cancer. The American Cancer Society recently based its recommendation for annual MRIs on risk assessments from the predictive models.

[Netterz]

I agree with you, that anyone should be able to get genetic testing done who has little or no knowledge of family history and that its a NO BRAINER that 3K for a test, vs hundreds of thousands of $'s later, fo treatment, not to mention th devestation this can cause a person, man or woman, to hae to go thru cancer, or many of the other diseases that can be detected this way. It just goes to show that we are not in control of our own health care, the insurance company is. One gets treated only WHEN and HOW the say you will. If they deem a test 'unnecessary' because they feel you arent at risk, the 6 mo or a year later your full blown with the disease... one word... LAWYER, because the only way to make them wake up and start allowing our care to be put back in the hands of you and your doctor, is to put a dent in there multi-billion $ pocket, and go straight to the media. I have never realy had anything serious before in m life, and can not believe how they totally control my health care. One expensive test after another, that they demand, before they will allow what obviously needs to be done from the start happen. "Have to justify the cost of each test, before you can have what you really need to have done, taken care of, or they wont pay or it" straight from my surgeons mouth. His hands are tied. And beleive me, there is a line for AOLT of the tests, because ALOT of people have cancer.

[godofredo29]

"(Men can get genetic breast cancer, too, but it's not common.) " You've got to love this. When it comes to men's health, so often we get airbrushed out before we even get the chance at some information. How about: men can get osteoporosis too, but its not common; or men can get hypothyroidism but it's not common; or men can get penile cancer caused by HPV, but its not common; blah, blah, blah, blah, blah.

[jennmarie620]

My father was adopted, and has no information on his birth family whatsoever. The adoption was closed because he was "surprise" baby from when his birth mother was living in California and her husband was working and living in Texas - so it will be very difficult to locate blood family members.

I already have an elevated risk for Cancer because I have polycystic ovarian syndrome - so I would like to know if I have a gene mutation that makes my chances of developing cancer even higher. But I know that the insurance companies won't care about all of that, just that they'll have to pay out $3000 for a genetic test.

You'd think the stupid insurance companies would get the hint that $3,000 for a test that could help a woman PREVENT cancer is a helluva lot less expensive than TREATMENT for cancer.

[jlayne38583]

I was adopted in 1945, I was born in Michigan, to a 16 year old girl who came from NC with her Mother and the father WAS A SAILOR they were not married, all that I would like to know is my medical history, I feel that the Insurance co. should pay for gene test on people who are adopted, and that way if they do not have to find their real family.

[Netterz]

I am going thru breat cancer, just found the lump 2 weeks ago. I can not beleive the waste of time, money, and aggrivation that the insurance companies dictate, when and what your doctor and you can do. YOu can not proceed with your treatment, until you hav a certain amount of testing doe, at incredible cost. Its bad enough to be told you have the "C" word, but then to be told that your doc's hands are tied to do anything outside my insurance co's guidlines, in risk of it not being paid for by the blue B&B. They have taken the ability of the doctor to use his medical knowledge, to do what needs to be done, and treat you, with the threat of not paying him, until he does as they say. And here I sit, with cancer in my body, and can not be treated in ANY manner, until he does there bidding. My cancer shows its moving, and agressive, so they could be shoving me into an early grave, by tying his hands. Something fo us all to think on, I had no idea.

[leidhold]

HEALTHCARE IN THE USA STINKS!!!



WHITE COAT CRIMINALS PREJUDGE MORE THAN THE AVERAGE JOE ON THE STREET.

WCC'S THINK THEY ARE DIEITIES!!!!!!!!!!!!!!!!!!!!!

LEIDHOLD---ALWAYS MY OPINION!!!!!!!!!!!!

WCC'S OUGHT TO GO TO JAIL!!!!!!!

[hmmagain]

' ... most of wuts wrong wit folk they never seek treatment for, and most of wut they seek treatment for is easy to fix, and most of wut isn't easy to fix can't be fixed, and most of wut can be fixed isn't affordable ... '

' ... the best doctors are the ones too busy and too broke to bother about the big houses and the fancy cars and have never even seen a golf course ... '