Experts Offer Better Means of Gauging Breast Cancer Risk

Then there are women with early-onset breast cancer but no history of breast or ovarian cancer, or patients with less than two female relatives surviving beyond age 45 on each side of their family. The model does little to help them, experts say.

In their study, Weitzel's team combed through information on more than 1,500 women cared for at high-risk breast cancer clinics in the United States.

They concluded that women under 50 with breast cancer and a limited family structure -- less than two females age 45 or older on either side of the family -- were almost three times more likely to beBRCAcarriers than women with adequate family structure.

BRCAgene mutations were found in 13.7 percent of women with limited family structure compared with 5.2 percent of those with adequate family structure.

Weitzel now believes that "family history is not a good tool. We shouldn't discriminate against women [who have limited family structure]. What if she's adopted? We lost whole generations to the Holocaust. Why should we deny them access to testing?"

In women with little family history to rely on, age may end up being a deciding factor in assessingBRCA-linked breast cancer risk.

Women under 40 who have breast cancer are usually tested for theBRCAmutations, but women in the next decade of life probably should be as well, the researchers said.

"Most crucial is the 40-to-50 age range," Weitzel said.

"Younger women who have breast cancer, especially those below 50, really should raise a red flag about genetic testing," Brooks added. "Age is a very, very powerful thing. The average age for developing [breast cancer] is 60. If you're developing disease 10 years before you're expecting to, that should raise a red flag."

"You're trying to predict who deserves the test," he continued. "With small family numbers, we may be underestimating who needs to be tested."

More information

There's more onBRCA 1andBRCA 2at the U.S. National Cancer Institute.

SOURCES: Jeffrey N. Weitzel, M.D., director, department of clinical cancer genetics, City of Hope Comprehensive Cancer Center, Duarte, Calif.; Jay Brooks, M.D., chairman, hematology, oncology, Ochsner Health System, Baton Rouge, La; June 20, 2007,Journal of the American Medical Association