Dear Jeff,

Our family are of Ashkenazi Jewish decent, and while thank God, we do not have a history of breast cancer in our family, my niece - who is 15 - wants to get tested for the possibility that she might get breast cancer one day. She has heard that there is greater chance of an Ashkenazi Jewish woman getting breast cancer than the average American woman.

I fear that she is over-reacting, but who am I to say she shouldn't be prudent? What if something shows up in the test? I just don't want her to live a life in fear. Her parents are divorced and I am not in touch with her mom to discuss it with her. What do you think?

This is an important question, especially in light of controversial legislation now under consideration which would encourage all female high school students to consider their risk for breast cancer. Breast cancer is scary; we all know someone affected by it-- especially among us Ashkenazi Jews who are at an increased risk.  So I can understand why your niece wants to get tested.

It is great that she is interested in her health and be pro-active, but unfortunately, getting a genetic test raises more questions than it answers.

Even with a "positive" result for the genetic mutation for breast cancer that is more common among Ashkenazi Jews (as well as African Americans) that terrifying genetic mutation may be of absolutely no significance.  Further, there's almost nothing one can do to prevent pre-menopausal breast cancer, other than perhaps not drinking too much and staying active, which is good advice, regardless of genetics.

My concern is that some young women, upon hearing they have an increased (although still relatively small) risk, will seek out drastic and disfiguring action- prophylactic bilateral mastectomy, a procedure wherein both breasts are removed to prevent a cancer they do not, and may never, have.  

So I encourage you to speak openly with your niece about breast cancer, and explain to her that her while her risk for getting breast cancer at a young age is very low, it is still something she should discuss regularly when she visits her doctor.