Breast cancer survivors are often concerned about the health of their relatives. This is a valid concern. Family members, especially their sisters, daughters and mothers, have an increased risk of getting breast cancer.
Breast cancer risk for family members
In general, the younger a woman is when she gets breast cancer, the more likely it is another member of her family will get it too. The risk tends to be highest in families where two or more immediate family members (mother, father, sister, brother, daughter or son) have had breast or ovarian cancer [146-147]. In these families, the history of breast cancer is often due to a genetic factor. A genetic risk for breast cancer can also be passed through the father's side of the family, so relatives on both sides should know about their family history and risks .
Learn more about family history and breast cancer risk.
Members of higher risk families may want to think about getting tested for mutations in genes linked to breast cancer. Testing raises many complex issues that families and individuals should consider carefully with the help of a genetic counselor.
In most cases, testing is first done on the family member with breast cancer. If no mutation is found, the cancer was probably not due to a genetic mutation and there is no need to test other family members. If a mutation is found, other family members can be tested for the specific mutation. If all family members with breast cancer are deceased, a genetic counselor can help you decide whether it is appropriate to have genetic testing.
Learn more about genetic testing. Information is also available on the National Cancer Institute website or by calling 1-800-4-CANCER.
What to tell your sisters, daughters and mothers
Assessing breast cancer risk
Breast cancer survivors should share their concerns with their families. Family members should consider seeing a health care provider to have their risk of breast cancer assessed. For those who find they are at higher risk, the drugs tamoxifen and raloxifene may be options for lowering their risk.
Learn more about tamoxifen, raloxifene and other options for those at higher risk of breast cancer.
Breast cancer screening
Women with a family history of breast cancer should talk to their health care providers about when they should begin screening for breast cancer. While screening does not lower the chance of getting breast cancer, it increases the chance of finding it early, when it is most treatable.
Learn more about breast cancer screening for women at higher risk.
What to tell your brothers, sons and fathers
Although breast cancer is more common in women, male family members of breast cancer survivors who have a BRCA1 or BRCA2 gene mutation are also at an increased risk.
Learn more about male breast cancer.
Learn more about BRCA1 or BRCA2 gene mutations and cancer risk.
Healthy behaviors for all family members
Healthy lifestyle choices promote overall health and may help protect against different types of cancer and other health conditions, such as heart disease and diabetes [60-61]. Some health behaviors might also help lower breast cancer risk. Breast cancer survivors and their family members should try to:
- Be physically active.
- Achieve and maintain a healthy weight.
- Get at least 2 ½ cups of fruits and vegetables every day.
- Choose 100 percent whole grain foods (like 100 percent whole grain breads and cereals, brown rice, popcorn and quinoa).
- Limit red meat and processed meat (choose chicken, fish or beans instead).
- Cut down on "bad" fats (saturated and trans fats), and eat more "good" fats (polyunsaturated and monounsaturated fats, like olive and canola oil).
- Get enough vitamin D and calcium every day. For women ages 51 to 70, this means 600 IU of vitamin D and 1,200 mg of calcium. For men ages 51 to 70, this means 600 IU of vitamin D and 1,000 mg of calcium.
- Take a daily multivitamin with 400 mcg of folic acid (often called folate on nutrition labels).
- If you drink alcohol, limit to less than one drink of alcohol a day (for women, and fewer than two drinks a day for men). Those who drink alcohol should try to get enough folic acid, either through a multivitamin or foods like oranges, orange juice, leafy green vegetables and fortified breakfast cereals.
- Limit postmenopausal hormone use.
- Choose to breastfeed children, if possible.
Adapted from the American Cancer Society’s Nutrition and Physical Activity Guidelines , Washington University School of Medicine's Siteman Cancer Center’s Your Disease Risk  and Institute of Medicine’s Dietary Reference Intakes for Calcium and Vitamin D .