At what age should people with a family history of breast cancer undergo genetic testing?

TopMD's "Let's Meet the Doctor" is a branded patient education column in the field of oncology. Since its launch, nearly a thousand top domestic experts in the field of oncology have been guests on the program, popularizing cutting-edge knowledge on cancer prevention, diagnosis and treatment for cancer patients.

In order to enable patients to understand the authoritative progress in tumor diagnosis and treatment while having a deeper understanding of the profession of doctor, the "Let's Meet the Doctor" column has launched the "High-end Dialogue" section, regularly inviting top experts in the domestic oncology field to share cutting-edge tumor diagnosis and treatment knowledge with patients, as well as their own medical journey.

We are very pleased to invite Professor Wang Jing, a famous breast surgery expert and professor of breast surgery at the Cancer Hospital of the Chinese Academy of Medical Sciences, to be our guest in this high-end dialogue. During the 2021 National Cancer Prevention and Treatment Publicity Week, this live broadcast was broadcast simultaneously on 9 platforms including Xinhuanet, Sina News, Tencent News, Tencent Video, Toutiao, Xigua Video, Baidu Health, and Qutoutiao, with an online viewing volume of 678,565 times, attracting great attention from patients and doctors.

What's going on with those young girls with breast cancer in the clinic? Is breast cancer really getting younger? What should young people with a family history of breast cancer do?

Is breast cancer getting younger?

Nowadays, we often see young breast cancer patients in their twenties and thirties in the outpatient clinic. Does this mean that breast cancer is getting younger? Director Wang Jing also revealed to us why this is happening.

Data released in 2020 showed that breast cancer has surpassed lung cancer to become the world's number one cancer. Of the more than 2 million breast cancer patients worldwide, 450,000 are in China. In China, the high-risk age for breast cancer is 45 to 55 years old, and 60% of breast cancers occur before menopause.

The peak age of breast cancer in foreign countries is 55 to 65 years old, which is 10 years later than the peak age of breast cancer in my country. Therefore, young breast cancer patients still account for a minority, but the total number of patients has increased, so there are more young people than before.

Why do people get breast cancer at a young age?

The youngest patient Wang Jing has treated in his career was only 19 years old. Some time ago, a breast cancer patient who was only 3 years old was reported abroad. This is also the youngest breast cancer patient in the world. This type of patients who get breast cancer at a young age is probably related to genetic factors.

The genetic genes for breast cancer mainly refer to BRCA1 and BRCA2. Carrying these two genetic genes is a high-risk factor for breast cancer. If the mother or grandmother has breast cancer, she may also carry this gene at birth. The probability of carrying these two genes developing breast cancer and ovarian cancer in the future will be higher than others, so people with a family history should check whether they are carrying this gene.

At what age should people with a family history of breast cancer undergo genetic testing?

There are now many technical means to help friends with a family history of breast cancer screen whether they carry genetic gene mutations, and it can be done by testing blood or saliva.

As for the age of testing, should it be done earlier or later? Will it be a psychological blow if you test too young? Will it affect your partner and marriage? Will it delay the disease if you test too late? Director Wang Jing is always asked such questions in the outpatient clinic. Her advice is: The doctor can only tell you that there are now testing methods for genetic gene mutations. Women with a family history of the disease need to make their own decisions on the specific time to test.

Dr. Wang Jing’s advice to all female friends!

Women who do not have a family history of breast cancer also need to pay attention to screening. After all, breast cancer has become the most common cancer in the world. When should breast cancer screening begin? How often should it be done? What kind of screening methods should be used?

Director Wang Jing said that normal women should start breast cancer screening after the age of 40, with a mammogram every 1-2 years and B-ultrasound follow-up during this 1-2 years. There is no consensus on which method is more accurate, mammogram or B-ultrasound, and more clinical research is needed to confirm it, so now it is recommended to combine the two methods for examination.

For those with a family history of genetic diseases, the frequency of examination should be higher, and it is recommended to be checked once every six months. In terms of detection methods, although the price of nuclear magnetic resonance is higher, it is also more accurate and can screen out smaller and earlier breast cancers, so she recommends that people with a family history of genetic diseases add a nuclear magnetic resonance screening.

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