Milestones After Loss
- Kyle Richards has shared that her youngest daughter, Portia, is weighing college options, a bittersweet milestone that comes years after losing her mother, Kathleen, to breast cancer in 2002.
- Given her strong family history, Richards has been open about the importance of genetic testing and understanding inherited cancer risk.
- The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
- For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
- Women who have a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Speaking on her Amazon Live stream on February 3, the 57-year-old actress and socialite shared that her youngest daughter Portia Umansky, who is set to turn 18 next month is “deciding right now” on her higher education options.
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After her daughter quickly said hi before returning to school, Richards told her fans about Portia, “I just am obsessed with her. She’s the youngest of four daughters, and, you know, it’s just all girls here, and she really pays attention to everything and orders these things to test them out and will come and tell me. She really is my go-to.
Richards continued, “So she went from diapers to going to college. She’s getting all her acceptance letters right now from the schools, and it’s just so weird to think that she’s going to be leaving and going to college.
But we won’t talk about that because it’s a happy day. I’m so happy for her.”
Recalling a recent conversation she and Portia had over dinner, about her college choices, Richards said one school was “freezing” and another had “no direct flights.”
Richards continued, “I would love for her to go someplace not as far, because she’s my last [daughter].”
According to BravoTV, Richards revealed in an earlier Amazon Live that Portia’s first “dream college” was the University of Miami.
“She was a manager of the boys’ tennis team and the basketball team, and now she’s just like, ‘I like to boss people around,'” Richards said in September 2024.
Kyle Richards’ Family History of Breast Cancer
In the summer of 2020, Richards revealed on an episode of RHOBH that she had a long family history of breast cancer which she admitted made her nervous for the safety of her sister, Kim Richards.
This reveal occurred when the sisters visited a surgeon’s office to plan Kim’s breast implant removal surgery for the implants she received after her lumpectomy.
In the episode, Richards opened up about losing her mother, Kathleen, in 2002 after a fight with breast cancer. Because of that experience, the family was especially alarmed when Kim had a possible breast cancer diagnosis in 2010.
Fortunately, doctors determined that the growth in her breast was noncancerous, and she underwent a lumpectomy to have it removed. Around that period, she also chose to get breast implants. Later on, when the implants deflated, she decided to have them taken out.
Richards said, “I don’t like anything to do with doctors and hospitals. My whole body goes numb. I go back to being in the hospital with my mom. The doctor sat us in a room and said, ‘Your mom has breast cancer,’ and it was stage 3 at that point.”
“My mom just wanted to pretend like she was fine, because she was so scared to die. And I can remember thinking, you know I kind of want her to be like, ‘It’s okay, this is life,’ but she wasn’t that person. She would tell me, she would say to me, ‘Kyle, I don’t want to die. I’m terrified and I still have so much to teach you,” she told the cameras.
Her sister thankfully talked to doctors about getting her implants removed and breasts lifted, but she also inquired on whether her family history of breast cancer should be something to worry about. Doctors assured Kim that if they found any abnormalities in the tissue they would address them.
Helpful Information About Breast Cancer Screening
Since Richards has a higher risk of getting breast cancer since her mother battled the disease, it’s important to understand when women should begin screening for this disease.
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives. For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
WATCH: Understanding the BRCA gene mutation
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Family History & Breast Cancer Risk
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
Expert Resources On Genetic Testing For Breast Cancer
- Genetic Testing For Breast Cancer
- Genetic Testing Is Increasingly Driving Treatment For Breast Cancer And May Actually Help Lower Costs
- Genetic Testing for Breast Cancer: What is This Type of Test? And What Do My Results Mean?
- New Study Identifies Genes Linked to Increased Risk for Triple-Negative Breast Cancer
- Should I Get Genetic Testing to Assess My Risk for Breast Cancer?
- The Incredible Angelina Jolie Effect: Nine Million Women Have Gotten Genetic Testing For Breast Cancer
Different types of genetic testing can help people with a family history of cancer better ascertain their cancer risks. Your doctor will discuss your family history of cancer with you in the context of your type of tumor and your age at diagnosis. Hereditary genetic testing is usually done with a blood or saliva test.
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those with a family history to get [genetic testing],” Dr. Ginsburg previously told SurvivorNet. “I would say that if you have anyone in your family diagnosed with a rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome.
The second test involves the genetic sequencing of your tumor if you’ve been diagnosed with cancer by this point. These genetic changes can be inherited, but most arise during a person’s lifetime. This process usually involves examining a biopsy or surgical specimen of your tumor. This testing can lead to decisions on drugs that might work against your cancer.
“Digital mammography, it turns out, significantly improves the quality of the mammogram… It’s 3D or tomosynthesis mammography,” Dr. Connie Lehman, the chief of the Breast Imaging Division at Massachusetts General Hospital, explains.
“This allows us to find more cancers and significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.
Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance.
Understanding Genetic Testing for Breast Cancer
Genetic testing for breast cancer is an “exploding” area, one SurvivorNet expert previously told us. And this revolutionary testing method is only going to become more of a common practice.
“It started out with a very narrow field of women and men who were recommended to have it based on certain risk factors, family history of breast cancer, or other cancers, and also ethnic backgrounds,” Dr. Elisa Port, a surgical oncologist at Mount Sinai, told SurvivorNet in an earlier interview.
“We now feel that casting a wider net with genetic testing is probably very prudent because finding out that one has a cancer predisposition gene can definitely change their course, their risk for cancer and what they might want to do about it.”
Who Should Receive Genetic Testing?
This type of testing is done to determine if a person has a specific mutation that puts them at a higher risk of developing cancer.
Genetic testing can be done on samples of blood or saliva, or from a swab of the inside of a cheek, according to the American Cancer Society. The samples are sent to a lab for testing.
The National Comprehensive Cancer Network (NCCN) recommends testing only select patients with risk factors for hereditary breast cancer. These include but are not limited to patients who were younger than 45 years old when they were diagnosed with breast cancer, those with a strong family history of this cancer, and those with Ashkenazi Jewish heritage.
Genetic testing for cancer is usually done in a doctor’s office (either your primary care doctor or an OB-GYN), but there are a few tests available for people to purchase commercially.
Where Can I Get Genetic Testing?
Before taking a genetic test to see if you have a higher risk of developing breast cancer, it’s important to be educated on the different types of gene mutations that increase your risk of this cancer.
The most common breast cancer gene mutation, and the one doctors have known about the longest, is the BRCA gene mutation. The BRCA1 (BReast CAncer 1) or BRCA2 (BReast CAncer 2) genes help cells repair their DNA damage. Having a change, or mutation, in one of these genes increases a woman’s risk of getting breast cancer. These gene mutations are commonly passed down in families; if a parent carries a BRCA gene mutation, there’s a 50-50 chance you could be carrying it as well.
Between 5% and 10% of breast cancer cases are thought to be hereditary. And about 10% of patients who undergo genetic testing will test positive for the BRCA1 or BRCA2 gene, Dr. Julie Rani Nangia, an assistant professor at Baylor College of Medicine, tells SurvivorNet.
“The genetic BRCA1 and (BRCA)2 mutations, if a woman has one of these mutations … it puts her at basically the highest quantifiable risk for getting breast cancer,” Dr. Port says. “We typically say between the 60 (percent) and 80 percent range. Having a BRCA1 and (BRCA)2 mutation also means that that person is at higher risk of getting breast cancer at an earlier age, and also maybe at risk for other cancers like ovarian cancer, like pancreatic cancer for men, prostate cancer and male breast cancer may be a concern.”
Since the discovery of the BRCA mutations in the 1990s, doctors have gone on to identify many other gene mutations that put people at a higher risk of developing breast cancer.
“There’s actually eight to 10 genes that also can put someone at a higher risk for breast cancer,” Dr. Port says, adding that usually that risk isn’t as high as the BRCA mutations. These additional gene mutations include PALB2, ATM, TP53, CHEK2, PTEN, CDH1 and STK11.
Should I Get Genetic Testing to Assess My Risk for Breast Cancer?
“We call them more moderate penetrance genes and those genes, the risk of breast cancer associated with them can be anywhere from say 20 percent to 50 percent. … so still very high, but lower than the BRCA genes that were the ones we originally described.”
The PALB2 gene is a “moderate penetrance gene, and the risk of getting breast cancer with PALB2 can be a pretty broad range,” Dr. Port says. “And unlike the BRCA genes where we don’t really use the family history of who got breast cancer to affect the risk estimates, with PALB2, you really can dial up risk or dial down risk depending on how many relatives and the age of the relatives in the family got breast cancer.”
Contributing: SurvivorNet Staff
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