Ashkenazi Jewish and BRCA breast cancer

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I have recently been looking into my family tree. I recently discovered that I have Jewish ancestry. It’s not that recent but on my dads side pretty much everyone was Jewish going back beyond my great grandmother.

A paternal aunt died of breast cancer in her early 30s. People with Ashkenazi Jewish heritage have a much higher risk of carrying the BRCA mutations that make you susceptible to cancer. Up to 80% chance of getting cancer in your lifetime.

Before I discovered my Jewish ancestry I undertook an ancestry DNA test with health reports. They will test for the BRCA (breast cancer gene) but the variations are the ones mostly present in people with Jewish ancestry. I had no idea this would include me when I signed up for the test. My results are not here yet. Should be here very soon.

Has this happened to anyone on here? Can anyone reassure me that the chances are very slim? The only thing that has thrown me is my aunt having aggressive cancer at such a young age. The only other cancer that I’m aware of is my grandfather having died of lung cancer.

There are NICE guidelines you can look up about referrals to specialist clinical genetics services that can test for BRCA (and vairations). It seems unlikely this test would have been undertaken as part of an ancestry report (as there needs to be appropriate genetic counselling in place etc.).

Even if your aunt had the BRCA gene (and most BC is not caused by the gene), there is a relatively small chance (25%) that you do too. Best step is to read the guidelines about BC family history and referral to secondary care services and have a discussion about the possibility of a referral. The referral will include family history on either side. My mum's family has a gene variation, but my referral mentioned my fathers Jewish ancestry. You can pay for the test privately too, I think it is about £1600. Best of luck.

As pp had said you really need to speak with your GP about getting a referral for genetic councelling. These tests shouldn't be carried out without this in place.

Thanks. It was a 23&me ancestry and heath Report.

This is what they say “ 23andMe offers a genetic test for three variants in the BRCA1 and BRCA2 genes to its Health +plus Ancestry Service customers. This genetic test detects three selected variants in the BRCA1 and BRCA2 genes – BRCA1 185delAG; BRCA1 5382insC; and BRCA2 6174delT – that are among the most studied and best understood. These three variants are most common in people of Ashkenazi Jewish descent.”

It's a bit late for that - she's had the test already! In my experience, the NHS will not refer you for genetic testing unless you have an extremely strong family history of breast cancer (i.e. more than one family member on the same side, or a first-degree relative with BC at a young age) but it would be worth asking your GP. If the test you have been offered by ancestry is the same as the one you would get on the NHS, just without the counselling, I think it's better to know. If it's positive for BRCA you can then go to your GP and request genetic counselling.

I opted to have the health component because I thought it would be interesting and I never even considered that I might have Jewish ancestry. I sent the test off back in December so results are due v soon.

The first I knew about it was on looking at my family tree! I was absolutely shocked to be honest.

This is why these tests are so dodgy in some instances, it's NOT what you want to find out from a random "fun" DNA test. I'd try to chill out - not all Jewish people are of Ashkenazi heritage for a start, let alone carry that gene.

If you have the gene you need to speak to your doctor about your options.

How old are you by the way?

I'm 100% Ashkenazi and have never heard that. There is breast cancer in my family, but all post menopause and so therefore unlikely to be genetic. I would try not to worry, and wait to see what the test result says.

I’m in my mid 30s.

I’m pretty sure it is Ashkenazi Jewish that my ancestors are. My dad did a different test (not health reports) just ancestry and he came back a proportion Ashkenazi Jewish.

The reason for the higher prevalence of certain genetic disorders in the Ashkenazi population is due to the fact that the current population is descended from just 350 individuals.

It’s suspected that catastrophic event around 800 years ago (disease, famine, persecution etc) decimated the Ashkenazi population in Europe and as a result the gene pool became very restricted.

www.nature.com/articles/ncomms5835

From what I understand the rest of the population chances of a BRCA mutation is 1 in 400 or 500. Those from Ashkenazi background: 1 in 40. I never knew this was a thing either until I started reading up on what it meant to have Jewish ancestry.

Just remember though that means you've got a 39/40 chance of not having it even if you are Ashkenazi.

And not everyone with the gene gets cancer.

Indeed you are right. I will sit tight and see what the results say. My aunt could have been a different gene entirely or just a very unfortunate unlucky event not related to hereditary cancer.

I am 50% Ashkenazi Jewish and was told that because of the higher risk of carrying the BRCA gene, if I had one relation (an aunt in your case) with breast cancer, I would be eligible for further testing on the NHS. If your aunt had breast cancer I’d suggest you get a referral for genetic counselling from your GP. This was from a breast surgeon after being referred to a breast screening clinic when I found a lump in my breast (all was fine). As I don’t think any relatives with breast cancer I haven’t had further testing.

BRCA gene can also be responsible for prostate cancer cases. Relevant to any males is your family

Wait for the results first of all. If you do carry the gene make an appointment with your gp, or if you have the facility email the gp with the result and request advice for what to do. Do not panic, it's increased risk not that you have bc, but the gp will support you to see the professionals you need to see and you can pass on the recommendation to direct family to also get tested via their gp on a non urgent basis.

My friend does carry the gene and there's implications for men too, his gp was excellent and he had enhanced screening which caught cancer early with full recovery. As others have pointed out even 1:40 jeans 39/40 don't!

Need to check but off the top of my head, the absence of related cancers (ovarian, prostate) if the only other cancer you found is lung cancer is significant. Most breast cancers are unrelated to BRCA variants (only 5-10% of cases? relate to this gene).

The statistics are complex but as most breast cancer deaths are not BRCA1 variant-related and your concern is based on a single case with no multiple family members and no ovarian, prostate and related cancers then your risk might be not significantly higher than the lifetime probability for women in general.

If in the UK, Ashkenazi Jewish heritage can give eligibility for rigorous non-commercial DNA testing. Most of the geographic traits the commercial DNA tests assert are unsound though it is possible the racial lineage in your test might be sound(er).

Update: I don’t have the BRCA variants they tested for (more common in Jewish) and the test also confirmed my Jewish ancestry

Hope this helps someone in the future! As I didn’t realise there was a link before I discovered my Ashkenazi Jewish ancestry.

I'm 100 percent ashkenazi Jewish on both sides.

Both of my grandmothers and my aunt died of breast cancer.

I had my dna sequenced by two different companies last year and I don't have any brca mutations (this was my main reason for doing it)

Cross posted. Glad you are also clear.