If you have a family history of breast cancer and are considering getting a genetics evaluation, prepare  for your appointment.

You'll need to know a lot about your family tree before you go, and that may mean doing some homework. So sit down, get on the phone with relatives, and inquire. Lots of patients will tell a counselor, "Aunt Trudy died of some kind of cancer but I don't know what kind." You need to know what kind if you expect an accurate assessment of your own risk.

Genetics counselors like to look at a family tree that includes at least three generations. That may turn out to be a lot of people when you consider aunts, uncles, cousins, grandparents, and their siblings. Cancers of particular note are those of the breast, ovaries, pancreas, skin (melanoma), and prostate, especially if your relative was fairly young at the time of diagnosis.

The risks of breast cancer can be significant for families carrying the BRCA1 or -2 gene. There's also a special gene, known as the Cowdens gene, that is associated with a disease called Cowdens syndrome and a higher risk of breast, uterine, and thyroid cancers.

Once you have as much family health history as you can gather, the genetics counselor will create a pedigree chart to look for disease clusters on either side of the family that may be of significance.

Request a copy of this chart to pass on to the next generation. Once you've accomplished this project with the help of a genetics counselor, your children and grandchildren should not have to reinvent the wheel.