✔ Backed by: Centers for Disease Control and Prevention (CDC) · U.S. Preventive Services Task Force (USPSTF). Each fact links to its source, and the full list is at the bottom of this post.
Families pass stories down at the kitchen table. Grandma’s famous pie recipe. The uncle who could fix anything. But sometimes the stories that matter most for our health are the ones nobody talks about. “Your aunt had some kind of cancer, I think.” “Your grandmother was sick when she was young, but we never really said what it was.” Those stories can also help you decide whether to ask about genetic counseling.
For breast cancer, those quiet family stories can matter a lot. During Breast Cancer Awareness Month, let’s talk about family history, the BRCA genes, and when it makes sense to ask about genetic counseling.
What are BRCA1 and BRCA2?
Everyone has BRCA1 and BRCA2 genes. When they work normally, they help keep breast, ovarian, and other cells from growing and dividing too fast [4]. But some people inherit a change, sometimes called a mutation, in one of these genes. A BRCA change raises the risk of breast, ovarian, and other cancers [4]. If your mother or father has a BRCA change, you have a 50% chance of having the same change [4].
Here is some perspective: the CDC says about 5% to 10% of breast cancers are hereditary, and about 3% come from BRCA changes [4]. So most breast cancers are not inherited. But for families where a BRCA change does run, knowing about it can help you and your care team plan screening and prevention.
Family history clues worth noticing
The CDC lists signs in a family’s history that may point to a higher chance of a BRCA change [1]:
- Several relatives with breast cancer
- Any relative with ovarian cancer
- A relative diagnosed with breast cancer before age 50
- A relative with cancer in both breasts
- A relative who had both breast and ovarian cancer
- A male relative with breast cancer
- Ashkenazi Jewish ancestry along with a relative who had breast or ovarian cancer
- A relative with a known BRCA change
Notice that this list includes the men in your family, and it includes both your mother’s and your father’s sides. Many people only think about their mom’s side when it comes to breast cancer. Your dad’s family counts just as much.
Gathering your family’s story
You do not need a perfect family tree to begin. Start with what you know, and ask gently about the rest. The details that help most are who had cancer, what kind it was, and about how old they were when doctors found it.
These talks can feel awkward. Some families never discussed illness. Some people were adopted, are estranged from relatives, or simply never knew certain family members. If you only know part of the story, that still counts. Share what you have.
You can say: “I’m putting together our family health history for my doctor. Do you remember what kind of cancer Grandma had, and how old she was?” Most relatives respond well when they understand you are asking to take care of yourself, and maybe to help them too.
What happens in genetic counseling
If your family history raises questions, a common next step is a visit with a genetic counselor or another health professional trained in cancer genetics. They help you understand your family’s history and your options [2]. A session can cover questions like [2]:
- Do I have a higher chance of breast, ovarian, or other cancers?
- Who in my family would be best to test first?
- How accurate is testing, and what could the results mean?
- How could the results affect my care and my relatives?
Here is something many people do not know: you can talk with a genetic counselor and still decide not to get tested. That is your choice [2]. If you do get tested, counseling afterward helps you understand what the results mean for you [2].
What the national guidance says
The U.S. Preventive Services Task Force recommends that primary care clinicians use a short family risk tool for women who have a personal or family history of breast, ovarian, tubal, or peritoneal cancer, or ancestry linked to BRCA changes. People whose results suggest higher risk should be offered genetic counseling and, if appropriate after counseling, genetic testing [3]. This guidance applies to people based on sex assigned at birth and is currently being updated [3].
In plain words: if your family history raises a flag, you can ask your primary care clinician about a risk check and a referral. You do not have to wait for them to bring it up.
Genetic counseling questions to ask at your next visit
- Based on my family history, should I see a genetic counselor?
- Can you refer me to someone trained in cancer genetics?
- If I am at higher risk, would my screening plan change?
- Will my insurance cover counseling and testing, and should I call them first?
Call your insurance plan before testing to ask what the plan covers. Coverage rules vary from plan to plan.
If a BRCA change is found: sharing the news with family
A positive result is not just about you. It can matter for your relatives too, and many people find this part the hardest. The CDC offers tips for these talks [5]:
- Start with the people most likely to share it. Parents, brothers and sisters, and children are most likely to have the same change. Aunts, uncles, nieces, nephews, and cousins are also more likely than the general public.
- Share the exact change you have. Your relatives’ doctors need to know the specific change so they can order the right test.
- Explain why it matters. Relatives can take steps to lower their risk or find cancer early.
- Go gently with children. Each child has a 50% chance of inheriting the change, but the CDC notes that genetic testing is usually not recommended for children. Answer their questions simply, and expect new questions as they grow.
- Ask for support. You do not have to have these talks alone. A genetic counselor can help you plan what to say.
You can say: “I learned something from a genetic test that could matter for your health too. Can we find a time to talk about it?” Giving people a heads-up, instead of sharing big news in passing, often makes the talk go better.
Let’s talk about it
How did you learn about your family’s health history? Was it easy to talk about, or did it take a few tries? If you have met with a genetic counselor, what helped you feel ready? Your experience could help someone take that first step.
One Tru Step: Text or call one relative this week and ask, “Do you know of anyone in our family who had breast or ovarian cancer?” Write down what you learn and keep it with your health records.
Sources and further reading
- CDC: People at Increased Risk for BRCA Gene Mutations
- CDC: Genetic Counseling for Hereditary Breast and Ovarian Cancer
- USPSTF: BRCA-Related Cancer Risk Assessment, Genetic Counseling, and Testing
- CDC: What Causes Hereditary Breast and Ovarian Cancers
- CDC: Talking to Family About Your BRCA Gene Mutation
Sources checked October 15, 2026. General education; individual care and coverage questions require an appropriate professional.
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