Dr. Anthony Provenzano
When most of us have a checkup, we fill out forms with questions about our medical history and that of our relatives. In addition, your physician will ask questions about this information. It may feel routine, but providing the most accurate and complete information is the first step in helping the doctor properly assess your health. Knowing if you have a loved one who had cancer, heart disease, or diabetes may give the caregiver clues about your own health and offer strategies for ways to stave off illness and keep you fit.
Dr. Anthony Provenzano, a medical oncologist at NewYork-Presbyterian Medical Group/Westchester and chairman of the Cancer Committee at NewYork-Presbyterian/Lawrence Hospital in Bronxville, explains, “Your doctor will use all this information to create a family health history, one that can help determine your risk for various medical conditions, including breast cancer.” A lack of important detail can leave us with unanswered questions, he notes.
For patients who have an immediate family member diagnosed with breast cancer, a family history is especially key in determining if others could be at risk. Genetic risk factors like the BRCA1 and BRCA2 hereditary mutations have been linked to the disease. And, more recently, others have been found. That’s why a more detailed family health history can help physicians and oncologists be more confident in interpreting cancer risk.
“Whether you were adopted or for other reasons, many of us simply don’t know a lot about our family’s health history,” says Dr. Provenzano. “We may know that a first or second degree relative had cancer, but not know what type or at what age they were diagnosed.” You should gather as much information as possible from your extended family—grandparents, aunts, uncles and cousins. “This way, you can create a family health history blueprint,” he adds.
Once you have the data for each relative who has had cancer, record the type of cancer, the person’s age at diagnosis, and whether the relative was on your mother’s or father’s side of the family. Ethnicity is also important. For example, those of Ashkenazi Jewish ancestry are more likely to have a BRCA mutation.
If a family health history suggests a woman might be at higher risk for breast cancer, she can then have genetic testing. These tests tell her whether the increased risk is due in part to an alteration or mutation in her genes. If she’s at higher risk, she may be screened earlier, more frequently, or with different kinds of tools—like an MRI. In some cases, she may be a candidate for primary prevention with a medication such as tamoxifen that can reduce her risk for developing breast cancer.
Finally, if you are found to be at a higher risk for hereditary cancer based on family health history alone, but tested negative for a mutation, you may still need repeated genetic testing as newer mutations are discovered, says Dr. Provenzano.
Genetic counseling and testing are available at NYP/Lawrence with our genetic counselor who is affiliated with the Columbia University Medical Center Clinical Genetics Program.
For information on how to put together a family health history visit hhs.gov
To find a doctor, visit nyp.org/lawrence or call (914) 787-5000.
55 Palmer Ave