Women of Ashkenazi (Eastern European) Jewish
Descent
In the coldest February,
as in every other month in every other year,
the best thing to hold on to in this world
is each other.
— Linda Ellerbee
More than 90 percent of the
estimated six million Jewish people living
in the United States are of Ashkenazi (Eastern
European) Jewish descent. “Ashkenazi” refers
to descent from Eastern European Jewish populations
primarily from Germany, Poland and Russia.
(Other Jewish people in the United States
may be of “Sephardic” descent—primarily
from Spain, parts of France, Italy and North
Africa).
All around the world, certain
genetic disorders are more common in various
ethnic, racial or geographic groups. For
example, sickle cell anemia is more common
among African Americans; cystic fibrosis
is more common among Caucasians. In the Ashkenazi
Jewish population, one such genetic disorder
is an increased susceptibility to breast
and ovarian cancer.
Researchers have recently
discovered that Ashkenazi Jewish women
are more likely to have certain alterations
in the genes “BRCA1” or “BRCA2” than
women in the general population. As many
as one in 40 Ashkenazi Jewish women (2.65
percent) might carry one of these alterations,
which could put them at higher risk for
developing breast and ovarian cancer. (For
women in the general population, about
one in 500 (0.2 percent) will have an alteration
in the BRCA1 or BRCA2 gene.)
What is the
risk of breast cancer for Ashkenazi Jewish
women?
For Ashkenazi Jewish women without
an inherited susceptibility to breast
or ovarian cancer, the risk of developing
breast cancer is the same as for women
in the general population—about
a 13 percent risk over a woman’s
lifetime.
For women who have inherited
certain alterations in the BRCA1 or
BRCA2 gene, the risk of breast (and
ovarian) cancer is higher. Women carrying
one of these gene alterations have
about a 14 to 87 percent chance of
developing breast cancer by the age
of 70, and about a 10 to 68 percent
chance of getting ovarian cancer by
age 70. (Those are average risk estimates.
The actual risk ranges from 40 to 73
percent for breast cancer and 6 to
28 percent for ovarian cancer. The
risk for any one woman with an alteration
could be higher or lower than the average.)
It is difficult to say what the exact
risk of breast cancer is, and it depends
on gene factors and age.
For more information about genes and
breast cancer, see Genetic Testing
and Counseling on page 81.
What special
challenges do Ashkenazi Jewish women
face?
The main challenge Ashkenazi Jewish
women face is their increased likelihood,
compared to women in the general population,
of having an alteration in a gene that
puts them at increased risk for breast
and ovarian cancer. However, an important
thing to know is that only 7 percent
of breast cancer in Jewish women is
due to alterations in the BRCA genes.
The vast majority of breast cancer
in the Ashkenazi Jewish population
of women is not due to inherited alterations
in BRCA genes.
What can Ashkenazi Jewish
women do?
- If you are an Ashkenazi
Jewish woman and have a strong family history
of breast and/or ovarian cancer in your
family, you may want to consider having
genetic counseling, and in some cases,
genetic testing to further understand your
(and possibly your children’s)
risk for breast and ovarian cancer.
However, genetic testing is not recommended
for the general population of Ashkenazi
Jewish women. See Genetic
Testing and Counseling for more
information and resources about genetic
testing and breast cancer.
- If you
are age 40 or above, get regular mammograms
and breast exams (talk to your health
care provider about how often). Spread
the word to women you know to do the same.
If you have a strong family history of
breast cancer, your healthcare provider
may recommend that you start mammograms
and clinical breast exams earlier.
- If you
have been diagnosed with breast cancer,
think about seeking treatment from one
of the three Comprehensive Cancer Centers
in North Carolina or from another
large cancer center. See our listing of North
Carolina Hospitals and Cancer).
- If you need help paying
for mammograms or treatment, see Financial
and Other Assistance.
- Be an
advocate for your health care. If you
have been diagnosed with breast cancer,
become informed about your diagnosis, treatment,
and long-term follow-up care.
Participate in making decisions about your care.
Use this Resource Directory to help you learn
more about your options and
to find additional resources for more information.
- Communicate as much and
as openly as possible with your health
care providers. If you are not comfortable talking
openly with a provider, look for another provider
whom you can trust.
- Think
about joining a Jewish women’s
health or breast cancer
advocacy organization (See Resources below).
Portions of the
above were adapted from Questions and Answers About Estimating
Cancer Risk in Ashkenazi Jews (National
Cancer Institute, 800.4.CANCER or www.cancer.gov),
Learning About Breast Cancer (National
Human Genome Research Institute, www.genome.gov),
and Hereditary Breast Cancer in Ashkenazi-Jewish
Persons (City of Hope, Dept. of Clinical
Cancer Genetics, Cancer Screening and
Prevention Program, www.infosci.coh.org/ccgh/cspp)
RESOURCES
Organizations
Hadassah: The Women’s
Zionist Organization of America
212.303.8094
www.hadassah.org
This Jewish women’s organization publishes
free brochures on genetics and breast cancer
risk, especially for women of Ashkenazi Jewish
descent.
National Cancer Institute’s
Cancer Information Service
800.4.CANCER (800.422.6237)
www.cancer.gov
One of the best resources available for cancer
patients, this government organization has
free booklets on genetics, breast cancer
and Ashkenazi Jewish women.
Sharsheret
866.474.2774
www.sharsheret.org
This organization of cancer survivors links
Jewish women diagnosed with breast cancer
with other Jewish breast cancer survivors
for peer support and information. Hosts breast
cancer seminars; transcripts available for
breast cancer, fertility and caring for children.
Books and More
Cancer in Two Voices,
by Sandra Butler and Barbara Rosenblum
(1996). An account of the authors’ identity
as Jewish women and as partners as they
live with advanced breast cancer, from
excerpts in their diaries.
Web Sites
Chicago Center for Jewish Genetic Disorders
www.jewishgeneticscenter.org
This site offers information about Jewish
genetic disorders, including hereditary breast
cancer.
Hereditary Breast Cancer in Ashkenazi-Jewish
Persons
www.infosci.coh.org/ccgp/cspp/akjinfo.html
This fact sheet describes the risk of hereditary
breast cancer in Ashkenazi Jewish women.
Learning About Breast Cancer, from the National
Human Genome Research Institute
www.genome.gov/10000507
This fact sheet describes hereditary breast
cancer and includes a section for Ashkenazi
Jews.
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