By Dr. Greg Sweat
If you’ve followed the news recently, you’ll likely heard about actress Angelina Jolie’s decision to undergo a preventive double mastectomy — a proactive approach she took to reduce her risk of developing breast cancer after learning she was a carrier of the gene. Thanks to advances in cancer research and diagnosis, some women, like Jolie, may be able to know their breast cancer risk well before it happens.
But what does this mean for your health and when should you talk to your doctor?
What You Need to Know
Approximately 12 percent of women in the general population will develop breast cancer in their lifetime. A woman’s risk of breast cancer increases at least 34 percent if she has inherited a harmful mutation in one of the breast cancer genes, otherwise known as BRCA1 and BRCA2. If this mutation is present it also means that her risk of ovarian cancer increases at least 41 percent.
This is certainly a different type of screening than a routine mammogram and is not for everyone. Unlike mammograms – which are recommended to start by age 40 or earlier for some high-risk individuals – testing for the BRCA mutations can begin as early as age 18.
Individuals recommended for the screening are women who do not have breast or ovarian cancer, but who (1) have family members with breast or ovarian cancer or (2) have a relative with a known mutation in the BRCA1 or BRCA2 genes.
The first step is genetic counseling. Here, a qualified health care professional will review family history and complete a genetic-risk assessment. Then, if advised to continue with genetic testing, your provider will make a recommendation for the method of screening and discuss treatment options as needed.
The screening process for the BRCA genes is a simple blood draw or mouth swab. However, there is a series of methods used in processing to ensure the most accurate results, which can take several weeks to receive. The test can also be expensive, so individuals want to be sure to talk with their insurance company to determine coverage for genetic testing.
Based on the results, some women may elect to treat or have preventive surgery. Certain medications have been shown to reduce the incidence of certain types of breast cancer in high-risk women, but have not been studied specifically in patients with BRCA mutations. Other high-risk women may elect to have a mastectomy to substantially reduce the risk of breast cancer or elect to remove their ovaries to reduce the risk of ovarian cancer. Although not 100 percent prevention, it is close.
Your Health Today
While BRCA testing is helping some individuals identify their breast cancer risk earlier, it still only impacts a small percentage of the population. In fact, only 0.2 percent of women have a BRCA mutation. However, there are still basic steps you can start taking today to reduce your risk of developing breast cancer.
- Be physically active.
- Maintain a healthy weight throughout life.
- Reduce your caffeine and alcohol intake.
As always, talk with your doctor first about your breast cancer risk and ways to help maintain a healthy lifestyle. He or she can discuss your risk and connect you with a genetic counselor as necessary.
This weekly sponsored Community Health Update is brought to you by Shawnee Mission Medical Center.
Greg Sweat, MD, is a long-time Prairie Village resident and Board-certified Family Medicine doctor at Shawnee Mission Primary Care, which has six locations throughout Johnson County. To find a doctor, call the ASK-A-NURSE Resource Center at 913-676-7777 or visit shawneemission.org/primarycare.