How would being at risk for hereditary cancers impact family planning?
People at risk for hereditary gynecologic cancers, such as ovarian cancer, have unique concerns regarding fertility and hormonal health. Ovarian risk reducing surgery and cancer intervention (such as chemotherapy) impact hormone production and fertility. Our healthcare team at UCSF can help you brainstorm a plan that is right for you, balancing family planning with cancer risk management.
How would having a BRCA1 pathogenic variant impact family planning?
People born female with BRCA1 have a higher risk of getting breast and ovarian cancer in their 30s and 40s compared to other hereditary syndromes. The majority of breast cancers in people born female with a BRCA1 pathogenic variant are “triple-negative” cancers, and these are more likely to require treatment with chemotherapy. Chemotherapy can negatively impact reproductive function, and delay the period of time when recommended to have children.
We encourage people assigned female at birth with BRCA1 in their late 20s-early 30s to speak to a reproductive endocrinologist to be informed of the availability of fertility preservation and other tests related to child bearing.
What is fertility preservation?
Fertility preservation involves saving eggs, sperm, embryos, or reproductive tissue so individuals can have biological children in the future. This is especially important for those facing medical treatments that may affect fertility, like risk-reducing surgeries or cancer treatments.
What are some strategies for communication about family planning?
Cancer risk management with family planning can be challenging and overwhelming. Still, honest and thoughtful conversations with family members is very important for making family planning and risk management decisions. Suggestions for communication include:
- maintain two-way communication with their partner.
- identify their gaps in knowledge and find credible sources of information.
- acknowledge complex emotional responses directly.
Our healthcare team at UCSF can help answer questions and facilitate discussions amongst family members.
For more on family planning communication, click here.
If someone has a genetic variant, what is the probability of passing that gene to one of their children?
Each child of a parent with a pathogenic variant has a 50% chance of inheriting the gene with the pathogenic variant and a 50% chance of not inheriting the gene with the pathogenic variant. Therefore, even in families with hereditary cancer, about half of the family members did not inherit the pathogenic variant that is causing cancer, and their risk of cancer is similar to the average person. Genetic pathogenic variants do not skip generations and it affects males and females equally.
What happens if both parents have a BRCA1 pathogenic variant?
If planning to have biological children, we recommend testing both partner. If both partners have a BRCA1 pathogenic variant, each child has a 25% chance of inheriting both pathogenic variants, which causes Fanconi Anemia.