Positive Results

Making the Best Decisions When You're at High Risk
for Breast or Ovarian Cancer

A book by Joi L Morris and Ora Karp Gordon, MD

About Joi

Joi L. Morris, BRCA2 positive mother of two, shares her experiences with genetic testing, high-risk surveillance and preventive surgery in the enthusiastically acclaimed book Positive Results. Read more

About Ora

Ora Karp Gordon is not only a gifted physician specializing in medical genetics but also a genetic counselor with a passion for sharing knowledge with her patients. Through Positive Results, she shares her knowledge about breast and ovarian cancer genetics with everyone. Read more

Positive Results is also available from:

Barnes & Noble




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BRCA and Family History

Every woman is at risk of breast and ovarian cancer. The question for each woman is, what is her individual risk of developing these diseases? The average woman has a one-in-eight chance of developing breast cancer in her lifetime and about a one-in-seventy-one chance of developing ovarian cancer in her lifetime. But women with a strong family history of either breast or ovarian cancer may be at significantly greater risk.

Many, but not all, women with a strong family history of breast or ovarian cancer may carry a mutation on one of the two BRCA genes, which significantly increases risk of both breast and ovarian cancer.

Should you consider genetic testing?

Positive Results discusses in great detail who should consider genetic testing for the BRCA genes, what is involved in the genetic testing process, and how to interpret genetic test results. Here are a few guidelines to keep in mind if you are considering genetic testing:

  • See a genetic counselor. If you need help finding a genetic counselor visit the National Society of Genetic Counselors.
  • The key to determining if genetic testing is appropriate for you is to create a family history diagram that includes all incidents of cancer on both sides of your family.
  • Breast cancer is prevalent in our society, and not everyone who has a relative with breast cancer needs genetic testing. Genetic testing for BRCA mutations is recommended for individuals who:
    • Have two or more relatives with breast cancer,
    • Have both breast cancer and ovarian, fallopian tube, or peritoneal cancer in the same person,
    • Have breast cancer in both breasts at any age,
    • Have a very early age of onset of breast cancer (before age 45),
    • Have breast cancer as a man, or a male relative with breast cancer,
    • Have a family history of breast, ovarian, fallopian tube, or peritoneal cancer and an Ashkenazi Jewish background.

Creating a Family Medical History

The most important step in analyzing whether genetic counseling and genetic testing should be considered is to look at your family history, especially the family history of breast and ovarian cancer on both your mother's and father's side of the family. Several tools available on the Internet to help you prepare this family health history. A good one is My Family Health Portrait developed by the office of the U.S. Surgeon General. It is easy to use and results in a diagram and notes about each person in the tree that you can save electronically or print and take with you to your doctor. The saved information is stored as a downloaded file on your computer. Nothing is saved on the website. When you return again to the Family Health History website you will need to access this file on your computer, so be sure to remember where you have saved it. Another handy feature is that if you need help from relatives in completing the history you can email the file to them. They can then access the information, update it, and return it to you. The Family Health History tool can be modified or "reoriented" to other family members, allowing them to piggyback off your work rather than having to start from scratch and re-enter the information.

If you consult a genetic counselor, he or she will likely have a family health history form for you to complete prior to your genetic counseling session.

Recommended Reading:

Hereditary Breast and Ovarian Cancer Resources

  • Facing Our Risk of Cancer Empowered (FORCE)
  • Sharsheret
  • Be Bright Pink
  • National Cancer Institute
  • Find a Medical Geneticist (an MD)
  • Find a Genetic Counselor

Breast Cancer Resources

  • Susan G. Komen for the Cure
  • Y-me National Breast Cancer Organization
  • BreastCancer.org
  • National Breast Cancer Coalition
  • Dr. Susan Love Research Foundation
  • National Cancer Institute
  • Young Survival Coalition
  • Living Beyond Breast Cancer
  • No Surrender Breast Cancer Foundation

Ovarian Cancer Resources

  • Ovarian Cancer National Alliance
  • Lynne Cohen Foundation for Ovarian Cancer Research
  • Foundation for Women's Cancer
  • Teal Toes
  • National Cancer Institute

Other Resources

  • Breast reconstruction basics
  • Breast Reconstruction Matters
  • Resources for women going without reconstruction