Skill Checkup: A 56-Year-Old Woman With a History of Breast Cancer and Pain in Her Ribs and Spine

Pavani Chalasani, MD, MPH

Disclosures

January 14, 2022

About 5%-10% of breast cancers are hereditary, and the most common cause of hereditary breast cancer is a BRCA1 or BRCA2 mutation (only rarely do the mutations coexist in the same person). A patient who carries a BRCA1 or BRCA2 gene mutation has a significantly increased risk of developing breast cancer. Moreover, BRCA1 and BRCA2 mutations cause approximately 20%-25% of hereditary breast cancers, respectively, and 5%-10% of all breast cancers. These risk ratios increase in carriers aged 70 years or older as well.

Some women with a BRCA1/BRCA2 mutation opt to have a prophylactic double mastectomy. Because the current patient did not have a BRCA mutation, she chose not to have a double mastectomy. When a BRCA mutation is present, such extensive surgery can reduce the risk of developing breast cancer by at least 90%. Other approaches include:

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