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Q:
I am a 51-year-old female perimenopausal woman. My mother got breast cancer when she was 40 (long before her menopause at 52). I have heard that premenopausal breast cancer is different from postmenopausal breast cancer. Will my inherited risk factor decrease after menopause?
A:
Yes, you are right that breast cancer that strikes in younger, premenopausal women tends to be more aggressive than in postmenopausal women, likely due to higher levels of estrogen. Estrogen is a hormone that serves as fuel to many breast cancers. That's why widely used treatments such as tamoxifen and aromatase inhibitors work by reducing estrogen levels in the body.
The fact that your mother had breast cancer before she reached menopause does put you at an increased risk for breast cancer. About eight percent of all breast cancers are hereditary, and about half of those are related to mutations in two breast cancer susceptibility genes, BRCA1 and BRCA2. Hereditary breast cancer is more common in premenopausal women, and is more likely to affect both breasts than nonhereditary breast cancer.
Your risk of breast cancer doesn't change once you reach menopause, however. In fact, breast cancer is much more common in postmenopausal women, and the risk of cancer increases with age.
I hope that you have shared your mother's medical history with your health care professional, and that you are having regular mammograms and conducting regular breast self examinations. You might also consider going for genetic counseling. Genetic counselors help identify your risk of hereditary disorders, analyze patters of risk in your family, and review options with you. They will also provide supportive counseling and serve as an advocate. Based on the information you receive from the genetic counselor, you may decide to be tested for one of the genetic mutations related to breast cancer—something that may be particularly important if you have a daughter yourself.
