Genetic Predictability in Breast Cancer Risk: Surgical Implications

Three hereditary breast cancer families with cancer control implications serve as the core of this report. To date, the precise genetics of breast cancer remains an enigma, with familial concentrations explained only in terms of empiric risk figures which show approximately a threefold increased risk over that in the general population. Recent data utilizing genetic and medicopathologic studies of breast cancer families have revealed that some families manifest associated malignant neoplasms, ie, associated with leukemia, lymphoma, and sarcoma, and with ovarian cancer. Other families have shown sitespecific inheritance of breast cancer which is consistent with autosomal dominant in some and autosomal recessive inheritance patterns in others. Thus, it appears that the inheritance of breast cancer is heterogeneous. When managing breast cancer families these considerations could be helpful in the surgeon's cancer control program (which includes continued surveillance of all relatives at cancer risk).