BRCA gene and cancer: What you need to know
If you have a family or personal history of cancer, understanding your genes can help you understand your health better. Genes are like a manual for your body; they provide instructions about how to grow and develop properly.
Normal BRCA genes play a role in preventing cancer in your body. But when you have a mutated BRCA gene, it means the gene is less effective at protecting your body from cancer. Having one of these genetic mutations does not mean that you will develop cancer. However, a BRCA gene mutation is one of the most common gene mutations linked to increased cancer risk.
Two common genes linked to a greater risk of cancer are the breast cancer 1 and breast cancer 2 genes, known as BRCA1 and BRCA2. People who have a mutation in a BRCA gene are at a higher risk of developing specific cancers, including breast cancer, ovarian cancer, pancreatic cancer, prostate cancer and melanoma.
Understanding whether you carry a BRCA gene mutation empowers you to make informed decisions about your care. If you have a family history of breast cancer, ovarian cancer or other cancers, talk with your care team about your risk.
BRCA1 vs. BRCA2
Every person has BRCA1 and BRCA2 genes. The purpose of these genes is to protect the body from developing cancer. People who are born with a mutation in the BRCA1 and/or BRCA2 genes are at a higher risk of developing cancer. The cancer types are similar between the two genes, but the exact cancer risk level differs in people who have BRCA1 vs. BRCA2 mutations.
For example, women with BRCA1 mutations are at a greater risk of developing breast cancer compared to women with BRCA2 mutations. Men with BRCA2 mutations are at a higher risk of developing prostate cancer compared to men with BRCA1 mutations.
Who is at risk for the BRCA gene?
Less than 1% of people have a mutation in one of their cancer genes, and having a cancer gene mutation doesn’t mean you will get cancer—only that your risk is higher. If you have the following risk factors in your personal and/or family history, talk with your doctor about whether genetic testing makes sense for you.
- Breast cancer, especially before age 50
- Ashkenazi Jewish ancestry
- Male breast cancer
- Ovarian cancer
- Prostate cancer
- Pancreatic cancer
- Multiple types of cancers in one person
- Confirmed gene mutation in a blood relative
- Family history of similar cancers
BRCA gene and hereditary breast cancer
While it’s not common to have a BRCA gene mutation—about a 1 in 400 chance—it’s estimated that about 5-10% of breast cancers are linked to an inherited gene mutation, with BRCA genes being the most prevalent.
Overall, about 12% of women in the general population will develop breast cancer. But in women with a BRCA1 or BRCA2 gene mutation, the risk of breast cancer increases to over 60%. Men with BRCA1 or BRCA2 gene mutations are also at an increased risk of male breast cancer.
It’s important to know that people with BRCA gene mutations tend to have an increased risk for certain types of breast cancer or breast cancer developing in multiple locations. Cancers linked to the BRCA genes also often develop at a younger age. Because of these risks, those with a BRCA gene mutation should talk with their care team about options to reduce their risk.
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Second primary breast cancer
Second primary breast cancer
Both types of BRCA gene mutations increase your risk for second primary breast cancer. This means a new breast cancer develops in a different place—often the other breast—after your original breast cancer diagnosis. The risk of second primary breast cancer is up to 40% in those with a BRCA1 or BRCA2 gene mutation. -
Triple-negative breast cancer
Triple-negative breast cancer
A common type of hereditary breast cancer associated with the BRCA genes, especially BRCA1, is triple-negative breast cancer. This type of breast cancer can be more aggressive and harder to treat. Triple-negative breast cancer is a type of cancer that does not have any of the receptors (proteins within breast cells) commonly found in breast cancer. As a result, prevention and early detection are very important.
Second primary breast cancer
Both types of BRCA gene mutations increase your risk for second primary breast cancer. This means a new breast cancer develops in a different place—often the other breast—after your original breast cancer diagnosis. The risk of second primary breast cancer is up to 40% in those with a BRCA1 or BRCA2 gene mutation.Triple-negative breast cancer
A common type of hereditary breast cancer associated with the BRCA genes, especially BRCA1, is triple-negative breast cancer. This type of breast cancer can be more aggressive and harder to treat. Triple-negative breast cancer is a type of cancer that does not have any of the receptors (proteins within breast cells) commonly found in breast cancer. As a result, prevention and early detection are very important.BRCA1 or BRCA2 mutation and ovarian cancer
Along with breast cancer, BRCA gene mutations affect your chances of developing ovarian cancer, as well as primary peritoneal cancer and cancer in the fallopian tubes. Women with a BRCA1 or BRCA2 mutation have a higher risk of developing ovarian cancer compared to the general population risk of 1%. It's estimated that about 15% of all cases of ovarian cancer are related to inherited BRCA gene mutations.
People with BRCA-related ovarian cancer tend to have a better survival rate at five years than those with other ovarian cancers. Also, treatments like chemotherapy may work better in those with BRCA-related ovarian cancer.
Women with a BRCA gene mutation should talk with their doctor about preventive steps. For example, a procedure to remove your fallopian tubes and ovaries can reduce the risk of both ovarian cancer and breast cancer.
BRCA gene mutations and other cancers
While breast cancer and ovarian cancer are the most common cancers related to BRCA gene mutations, both men and women with these gene mutations also have an increased risk of other cancers.
Some additional cancers linked to the BRCA genes include:
- Prostate cancer: Both BRCA1 and BRCA2 gene mutations increase a man’s risk of prostate cancer.
- Pancreatic cancer: Men and women with BRCA gene mutations have an increased risk of pancreatic cancer.
- Melanoma: Melanoma (of the eye and skin) is more likely in those with a BRCA2 gene mutation.
Talk with your doctor about additional cancer screenings or preventive steps that could help reduce your risk of these cancers.
Genetic counseling and BRCA testing
When you know your genetic risk factors for cancer, you have the power to choose the right path for you. Baylor Scott & White offers genetic counseling for a variety of cancers and high-risk assessments for those with a personal or family breast cancer history. Based on your individual risk profile, your healthcare team can recommend your next steps for care, prevention and testing for other family members.
Frequently asked questions
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Can you get breast cancer without a BRCA gene mutation?Yes, you can get breast cancer without a BRCA gene mutation. Most people who have breast cancer don’t have a genetic cause. Only about 5-10% of breast cancers are related to an inherited genetic mutation. You can also have a BRCA gene mutation and never develop breast cancer.
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Can the BRCA gene be passed from father to daughter?Yes, daughters inherit one copy of the BRCA genes from their father and one from their mother. If your father carries a BRCA gene mutation, there’s a 50% chance this mutation will be passed on to you.
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Which BRCA gene mutation is worse?A BRCA1 gene mutation leads to a higher risk of ovarian cancer and breast cancer, including triple-negative breast cancer, in women when compared to BRCA2 gene mutations. On the other hand, in men, the risk of male breast cancer is higher with BRCA2 mutations than with BRCA1 mutations.
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How much does a BRCA gene mutation increase the risk of breast cancer?Depending on the BRCA gene mutation you have, it can increase your chance of developing breast cancer to over 60%. For comparison, the lifetime risk of developing breast cancer in the overall population is about 12-13%.
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Do breast cancer gene mutations only affect women?No. Breast cancer gene mutations can also place men at a higher risk for cancer. For example, men with a BRCA2 gene mutation are at a higher risk of developing male breast cancer, prostate cancer, pancreatic cancer and melanoma. It is equally important for men to receive genetic counseling and testing based on their family history of breast cancer.