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Monday, March 10, 2014
Very Strong Family History and Adenomas
My mother passed away at 52 from lung cancer. My dad was 61 at diagnosis of bladder cancer and 66 at his death. My sister was 35 at diagnosis of breast cancer and is still in the middle of her fight 2 years later. My grandfather died around 50 from brain cancer. A pituitary tumor, I believe. I am 31. I am just wondering if my family history puts me at a strong risk for cancer. And what should I look out for? I have had adenomas removed from my breasts and ovaries. I started my period at 8 years old and have always had irregular, weird periods. I smoke minimally - about 1-5 cigs per day. I am currently on Chantix to stop all together. I have smoked for almost 20 years. All of my docs are aware of the history. Lately though I am wondering if I should be doing more to keep an eye on things. My questions are, does all of that family history increase my chance? and what cancer is most likely?
This family history is certainly concerning, but does not really demonstrate a clear pattern suggestive of a hereditary condition. Your sister's breast cancer certainly occurred at a young age, and this increases your breast cancer risk. Based on her age of diagnosis, you should certainly be getting regular clinical breast exams and annual mammograms. There are hereditary breast cancer syndromes (most common is Hereditary Breast and Ovarian Cancer syndrome), but with only one case of breast cancer, although young, this may not explain the cancers in your family.
If your mother was not a smoker, her young lung cancer is concerning. There is a very rare condition known as Li Fraumeni syndrome that increases cancer risk, but again, it's not clear that your famiily meets the criteria for this syndrome either. Your grandfather's brain cancer may fit, but I don't know if he is your mtoher's or father's father. Your father's bladder cancer seems less concerning as far as heredity is concerned, since his age of onset was later.
Genetic counseling may be helpful to clarify your risks. You can find a genetic counselor in your area by asking your doctor or the link provided.
Doreen M Agnese, MD
Clinical Associate Professor of Surgery
College of Medicine
The Ohio State University