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.