Hereditary Breast and Ovarian Cancer (HBOC)
|Hereditary breast and ovarian cancer (HBOC) is an inherited condition that is associated with an increased risk of the following cancers:
HBOC affects both men AND women. It is caused by mutations or changes in the BRCA1 or BRCA2 gene. People with a first-degree relative (mother, father, sibling, child) with a BRCA mutation have a 50% chance of also having the mutation.
Should I be tested for HBOC?
People with a significant personal or family history of the above cancers should be referred for genetic counseling to discuss their risk. But what is a significant personal or family history? This includes people who:
1. Have a family member with a known BRCA1 or BRCA2 gene change (mutation)
2. Are Ashkenazi Jewish
3. Have a personal history of cancer:
- Have a personal history of breast cancer before the age of 45
- Have a personal history of breast cancer before the age of 50 AND a family member with breast cancer or prostate cancer
- Have a personal history of breast cancer at any age and close relatives with histories of breast, ovarian, prostate, or pancreatic cancer
- Have a personal history of ovarian cancer at any age
- Have a personal history of “triple-negative” breast cancer
- Have a personal history of male breast cancer, pancreatic cancer, OR metastatic prostate cancer at any age
- Have a personal history of high-grade prostate cancer AND relatives with a history of prostate, pancreas, breast, or ovarian cancer
4. Family History:
- Has not had cancer, but has a family member (mother, father, sibling, aunt, uncle, child) who meets one of the above criteria
Family History and HBOC
Family history plays a key role in finding people at risk for HBOC. Your doctor or genetic counselor can use family history to help decide if you should have genetic testing for HBOC. There are many resources that have been made to help with risk assessment. The U.S. Preventive Services Task Force (USPSTF) has several recommended resources for assessing risk, including the National Cancer Institute's Breast Cancer Risk Assessment Tool. In addition, the CDC has created the Bring Your Brave campaign, and MDHHS has developed the hand-held Cancer Family History Guide.
If HBOC is suspected based on personal and family history, the next step is to talk to your health care provider and look for genetic counseling from a qualified professional.
Cancer Genetic Counseling and Testing for HBOC
Cancer genetic counselors are professionals who have specialized education in genetics and counseling to provide information on your risk of developing cancer. Genetic counselors can work with you and your doctor to understand complex genetic information and help you make informed decisions. They can also provide emotional support as you make these decisions.
Genetic counseling is a process that helps identify a person’s risk of HBOC. Genetic counseling does not always lead to genetic testing and a patient can always choose not to undergo genetic testing.
A genetic counseling session can include:
- Gathering of individual and family health history
- Assessment of cancer risk
- Genetic counseling before and after any recommended tests
- Informed consent for all recommended procedures
- Guidance on cancer prevention measures, in case of positive test results
- Possible screening of family members who may carry the same mutation
Genetic counseling and genetic testing can help determine if a person’s cancer is inherited and whether family members have a higher chance of developing the same cancer. Having this knowledge is the first step in cancer prevention and intervention. It can protect the health and save the lives or relatives who are at-risk.
For more information about cancer genetic counseling please see the MCGA and MCC Joint Position Paper: Genetic Counseling and Testing for Hereditary Cancer Predisposition Syndromes (pdf).
To find a genetic counselor near you, please see: Genetic Counselors in Michigan
If you have questions, call the MDHHS Genetic Information Line at 1-866-852-1247 or email firstname.lastname@example.org. For cancer genetic counseling and testing services in your area, visit the Directory of Clinical Cancer Genetic Services in Michigan.
Funding for this program was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written materials, publications, or webpages do not necessarily reflect the official policies of the U.S. Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Last updated: 5/14/2019