The most sorely neglected portion of a patient's medical evaluation pertains to the family history of cancer of any type, including breast cancer. This is paradoxical—no one is at greater risk for breast cancer than a woman whose mother or sister had breast cancer (or another integrally associated hereditary syndrome cancer) and who is in the direct genetic lineage of a relative with hereditary breast cancer (HBC). The lifetime breast cancer risk for such a patient is 50%! Recognition of HBC, particularly when targeted surveillance/management programs are enforced for such high-risk patients, could be one of the most powerful and potentially cost-effective models for cancer control. Research on patients with HBC holds promise for the elucidation of etiology, biomolecular markers of the cancer-susceptible genotype, and carcinogenesis. However, success in all of these ventures will necessarily be contingent on the meticulous compilation of the family history.
This commentary on HBC in
LYNCH HT. The Family History and Cancer ControlHereditary Breast Cancer. Arch Surg. 1990;125(2):151-152. doi:10.1001/archsurg.1990.01410140025004