What should I do if I have a family history of breast cancer?

Written in association with: Dr Shiroma De Silva-Minor
Published: | Updated: 04/04/2024
Edited by: Conor Lynch

In this article below, revered consultant medical and clinical oncologist, Dr Shiroma De Silva-Minor, offers expert pieces of advice to patients who have a family history of breast cancer.

What should I do if I have a family history of breast cancer?

If you have a family history of breast cancer, as a breast oncologist, I recommend taking proactive steps to manage your risk. Here are some important considerations:

 

  1. Understand your risk: It is important to know your family history of cancers and understand your personal risk. If you have a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer, your risk is higher than the general population. Consider other cancers that can also be related to genetic mutations, such as ovarian cancer (including fallopian tube and primary peritoneal cancers), male breast cancer, and to a lesser extent other cancers such as prostate, pancreatic cancer, and melanoma. Remember, cancer genes can affect both men and women so it is important to consider the risk for male relatives as well.
  2. Early detection: Early detection is key to successful treatment of breast cancer. It is important to start screening mammograms earlier and more frequently than the recommended age of 50 for the general population. It may be appropriate for women with a family history of breast cancer to begin mammogram screening 10 years or more before standard screening age, depending on the level of risk. Find out more information on familial breast cancer. (www.nice.org.uk – will be hyperlinked in article)
  3. Genetic testing: Genetic testing can help determine if you carry an inherited gene mutation that increases your risk of breast cancer. If you test positive for a gene mutation, you can take steps to manage your risk, such as increased surveillance, chemoprevention, or risk reductive surgery.
  4. Lifestyle changes: While family history cannot be changed, making lifestyle changes can help lower your risk of breast cancer. This includes maintaining a healthy weight (BMI under 25), healthy eating (limiting processed foods and refined sugars and carbohydrates), exercising regularly, limiting alcohol intake, and avoiding tobacco.
  5. Consult with a specialist: If you have a family history of breast cancer, consult a breast cancer specialist to assess your risk, whether genetic testing should be under taken and for personalised risk-management strategies.

 

It is important to remember that only five to 10 per cent of all breast cancers are hereditary, and even if a genetic mutation is identified, it does not mean that cancer is an inevitability. Knowledge is power, allows you options, and arms you with the information you need to make the right decisions for you and your family.

 

If you’d like to make an appointment today with Dr Shiroma De Silva-Minor, head over to her Top Doctors profile to do just that.

By Dr Shiroma De Silva-Minor
Clinical oncology

Dr Shiroma De Silva-Minor is an accomplished and experienced consultant breast oncologist who specialises in breast cancer (both male and female), breast screening, chemotherapy, radiotherapy, immunotherapy, intraoperative radiation therapy, inflammatory breast cancers, HER2 positive disease, triple-negative breast cancers and breast cancer in pregnancy.

Dr De Silva-Minor oversees the entire (non-surgical) breast cancer pathway so she can advise on all aspects of treatment, including genetic counselling and testing, systemic (chemo) therapy, radiotherapy, and lifestyle factors in optimising health and minimising disease recurrence.  Dr De Silva-Minor was a Consultant Clinical Oncologist at the Oxford University Hospitals NHS Foundation Trust from 2008 till 2024 and recently left the NHS. The doctor now  has a private practise at the Cromwell Hospital in London and GenesisCare in Oxford.

Dr De Silva-Minor, whose clinical expertise is in the treatment of early, metastatic and recurrent breast cancer, notably obtained her first medical qualification in 1995, with her medical doctorate from the prestigious Cardiff-based University of Wales College of Medicine. In 1999, Dr De Silva-Minor was awarded the Membership of the Royal College of Physicians (UK).  Dr De Silva-Minor undertook  specialist oncology training at centres of oncological excellence in London, including The Middlesex Hospital, The Royal Free Hospital, as well as The Royal Marsden Hospital, amongst others.

In 2003, Dr De Silva-Minor was awarded the Fellowship of the Royal College of Radiologists and was also recognised as a clinical oncology specialist on the General Medical Council's register in 2007. 

Dr De Silva-Minor has published extensively in peer-reviewed journals. During a Fellowship in head and neck radiation oncology at The Princess Margaret Hospital in Toronto, Canada, Dr De Silva-Minor was awarded the Prize for Academic Excellence by the Princess Margaret Hospital and the University of Toronto for her research into the use of PETCT scans (Positron Emission Tomography) when identifying head and neck tumours for treatment with radiotherapy.   Dr De Silva-Minor was a member of the breast cancer expert panel for the National Institute of Health and Clinical Excellence (NICE), updating clinical guidelines on breast cancer management.

Dr De Silva-Minor is also collaborating on a metanalysis with the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) to bring together the research on radiotherapy clinical trials to better understand how to optimally treat breast cancer patients with radiotherapy.  Dr De Silva-Minor is a member of the Advisory Board on Cancer in Pregnancy (ABCIP), an international panel of experts in managing breast cancer in pregnancy. 

Dr De Silva-Minor is a passionate advocate for empowering her patients to be involved in their management decisions. Treatment is completely bespoke to individual patients, their specific tumour subtype, taking into consideration the individual's beliefs, wishes and personal circumstances.

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