Hereditary Breast and Ovarian Cancer Syndrome (HBOC)

Hereditary breast and ovarian cancer syndrome (HBOC) is an inherited disorder that when present multiplies the patient’s risk of getting breast cancer and/or ovarian cancer. It may explain why a patient has breast and/or ovarian cancer and may help identify additional family members with the syndrome. Most cases of can be detected through testing for mutations in the BRCA1 and BRCA2 genes.

Symptoms: Although symptoms of BRCA related breast and ovarian cancers are similar to non-inherited breast and ovarian cancer, the true advantage is using the knowledge to avoid cancer altogether (prevention) or to detect cancer very early (early detection).

Risk factors/ “Red Flags:

  • A personal history of breast cancer under the age of 50.
  • A personal history of breast cancer in both breasts.
  • A personal history of breast a second breast cancer.
  • A personal history of breast cancer and Ashkenazi Jewish ethnic background.
  • A personal history of ovarian cancer.
  • A family history that includes multiple breast and/or ovarian cancers on the same side of the family.
  • A family history that includes breast or ovarian cancers in the family and Ashkenazi Jewish ethnic background.
  • A family history that includes male breast cancer.
Screening/Prevention: Today, there are modalities such as mammography, breast MRI, ultrasound, medications, and risk reducing surgeries that can be employed to help manage the risks. Doctors can’t totally nullify the risk but they can reduce it by 90 percent or more.

Incidence:
Breast cancer ranks second in cancer deaths in women just behind lung cancer. In the United States, more than 190,000 patients will be diagnosed with breast cancer and more than 40,000 women will die annually. Approximately 5-10% of breast cancers are due to HBOC.

Ovarian cancer ranks fifth in cancer deaths among women and causes more deaths than any other reproductive cancer. In the United States, more than 21,000 patients will be diagnosed with ovarian cancer and more than 14,500 women will die annually. Approximately 10% of ovarian cancers are due to HBOC.

The risk of developing breast cancer by the age of 70 can be as high as 87% (the usual quoted number for the “everywoman” is 7%). For those who test positive, the risk of ovarian cancer can be as high at 44% and there is one study reporting the risk as high as 60% (the usual rate is in the range of 1–2%).