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 NorthAfrica).
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 Chapter 4: Genetic Testing and Counseling.
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 seven 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 Chapter 4: 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 Chapter 13: North Carolina Hospitals and Cancer Centers.
- If you need help paying for mammograms or treatment, see Chapter 7: 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.
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), and Learning About Breast Cancer (National Human Genome Research Institute, www.genome.gov).