When should children be tested if a parent has breast cancer?

Question

Hello doctor,

My wife is 44 years old and was recently diagnosed with triple-negative breast cancer. She underwent cancer genome testing, and the results have left us very confused and anxious.

She tested positive for a BRCA1 mutation, which explains why she developed breast cancer at a young age. This has made us extremely worried about our 16-year-old daughter and whether she might also be at risk.

The oncologist said her tumor is aggressive, but genetic testing shows it may respond well to certain chemotherapy drugs. She has started Carboplatin and Paclitaxel (Taxol). However, the side effects are severe, she has nerve pain in her hands and feet (neuropathy), significant hair loss, and persistent nausea despite medications.

The genome test also showed Lynch syndrome, which increases the risk of colon and uterine cancers. The doctor is suggesting a preventive hysterectomy after chemotherapy, but she is only 44, and we were still hoping to have another child.

Our insurance is also questioning coverage for some targeted therapies suggested based on genetic testing.

We would like to know:

Should our daughter get BRCA testing now or later?
How serious is Lynch syndrome?
Should I also worry about my own cancer risk?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query.

I can truly understand how frightening and overwhelming this situation must be for you and your family. It is completely natural to feel anxious when someone you love is facing cancer, especially with so many complex test results and treatment decisions. I sincerely hope and pray for your wife’s smooth recovery.

At this point, I do not know the exact stage of her cancer (stage I, II, III, or IV), which tells us how advanced the cancer is and whether it has spread. However, being diagnosed with triple-negative breast cancer does not mean that treatment is impossible. It simply means that the cancer does not respond to certain hormones, so we rely more on chemotherapy and newer targeted treatments.

Since her tumor is BRCA (breast cancer)-positive (meaning she carries a genetic change that increases cancer risk), she may benefit from medicines called PARP or poly adenosine diphosphate-ribose polymerase inhibitors. These are special targeted drugs that attack cancer cells with BRCA mutations, especially in advanced stages.

Chemotherapy can cause several side effects, such as hair loss, low white blood cell count (called neutropenia, which means reduced immunity and higher risk of infections), mouth sores, and nausea with vomiting, but these effects are usually temporary and can be managed with proper medications and supportive care.

Although these effects feel scary, the good news is that they are usually temporary and reversible once chemotherapy is completed. We also have good medicines and supportive care to manage these symptoms.

Regarding your daughter, since she is only 16 years old, genetic testing is usually not done now. It is generally recommended around 25 years of age, when screening and prevention can actually begin.

If you are planning another child, there is an option called egg freezing, where eggs are stored before chemotherapy to preserve fertility. Since treatment has already started, it is usually advised to wait at least two years before planning a pregnancy.

I hope this explanation helps you understand things more clearly. Please remember that you are not alone, and your medical team will guide you step by step through the safest decisions for your wife and family. Follow-up to be done after seven days.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.