Question from Kelbri27: My son died from rhabdomyosarcoma of the prostate 3 yrs ago. According to some studies, mothers of young children diagnosed with sarcomas have a higher risk of breast cancer. I am 41, and had one mammogram at 39. Should I request of my Dr. a mammogram combined with an ultrasound annually due to this supposed higher risk?
Response from Deborah K. Armstrong, M.D., Johns Hopkins Kimmel Cancer Center: I am truly sorry for your loss. You are correct to be concerned about your own breast cancer risk given the history of sarcoma among your loved ones.
The clearest link between sarcoma and breast cancer is in families with the Li-Fraumeni Syndrome (LFS). LFS is caused by inheritance of an abnormal or mutated p53 gene. The classic tumors that have been seen in LFS are breast cancer, sarcomas, adrenal tumors, leukemia and some brain tumors.
Fortunately, LFS is rare; there are estimated to be 200 or fewer families with LFS in the US. A family history that is suggestive of LFS would include three or more close relatives with early onset cancers (before age 45) with one of those family members having a sarcoma.
If your family cancer history is suggestive of LFS, you should see a cancer genetic counselor and consider genetic testing of at-risk family members. For now, since you are age 40, you should be having annual mammograms, be performing monthly breast self examination and have a clinical breast examination yearly.
Ultrasound can sometimes be a helpful addition to mammography but is not routinely used for cancer screening.