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In a study that evaluated two generations of women with BRCA1 or BRCA2 mutations, breast and ovarian cancers tended to be diagnosed at a younger age in the later generation. These results were published in Cancer.

Inherited mutations in two genes—BRCA1 and BRCA2—have been found to greatly increase the lifetime risk of developing breast and ovarian cancer. Mutations in these genes can be passed down through either the mother’s or the father’s side of the family.

Options to manage this increased cancer risk include regular cancer screening, chemoprevention (use of medications to reduce risk), or preventive surgery (surgery to remove the breasts and/or ovaries before cancer is diagnosed).

Breast cancer screening for high-risk women typically begins at a younger age than for average-risk women and involves both mammography and magnetic resonance imaging (MRI). As additional information becomes available about the expected timing of breast and ovarian cancer in high-risk women, it could influence recommendations about when to begin screening or prevention.

To explore how age at cancer diagnosis varies across generations, researchers at the MD Anderson Cancer Center evaluated 106 families with a BRCA-related breast or ovarian cancer in at least two generations.

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Breast and ovarian cancer tended to be diagnosed at a younger age in the younger generation. The median at diagnosis was 42 years in the younger generation compared with 48 years in the previous generation.

The researchers also used a more complex statistical model that was designed to assess changes in disease timing over generations. The results of the model suggested that younger generation of BRCA carriers would be diagnosed almost eight years earlier than the previous generation.

Some of the earlier diagnosis among the younger women may be the result of better screening tests or increased surveillance. Nevertheless, it’s possible that the cancers actually developed at a younger age in the younger generation. Information about when family members were diagnosed with cancer may help women with BRCA1 or BRCA2 mutations decide when to begin cancer screening or prevention.

Women with a BRCA1 or BRCA2 mutation are advised to talk with their healthcare provider about how best to manage their cancer risk.

Reference: Litton JK, Ready K, Chen H et al. Earlier age of onset of BRCA mutation-related cancers in subsequent generations. Cancer. Early online publication September 12, 2011.

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