How to take the family history

When and how do I take a family history?
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Take a family history of breast cancer when the woman expresses concerns about her family history, or if concerns arise during the consultation (for example the woman has breast symptoms, or concerns relating to use of hormone replacement therapy or oral contraceptives).[/color

Ask whether a faulty gene has been identified in the family.
Ask whether any first- or second-degree relatives (on the maternal or paternal side of the family) have had breast cancer – See below.
To be considered relevant, all affected relatives must be on the same side of the family and be blood relatives of the woman and of each other.
Paternal history is relevant if there are two or more relatives diagnosed with breast cancer (or related cancer) on the woman’s father’s side of the family.

Try to gather detailed information (such as the age when diagnosed, certainty of the diagnosis).
If there is a positive first- or second-degree family history, also determine:
Whether other cancers have occurred in the family, specifically:
Ovarian cancer.
Sarcoma at younger than 45 years of age.
Glioma, or childhood adrenal cortical cancer.
Complicated patterns of multiple cancers at a young age.

If any family member has had bilateral breast cancer (each breast cancer has the same count-value for risk as one relative, that is, the family member would count twice: once for each breast with cancer).
If there is Jewish ancestry.
Where appropriate encourage the woman to discuss the family history with relatives.

. Family history.
Degree of relative .
First-degree relative- Mother, father, daughter, son, sister, brother
Second-degree relative- Grandparents, grandchildren, aunt, uncle, niece, nephew, half-sister, half-brother
Third-degree relative – Great-grandparents, great-grandchildren, great-aunt, great-uncle, first-cousin, grand-nephew, grand-niece.

Dr G Mohan.