As you know, October is Breast Cancer Awareness Month so be sure to check back each week throughout the month as we share important breast health tips.
If you haven’t heard of BRCA testing, the first thing you should know is that BRCA stands for “BReast CAncer.” It became popular in the late 1990s but didn’t evolve into a true staple for early cancer detection until the last five to ten years. In addition to identifying a person’s lifetime risk for breast cancer, it’s also helpful in finding a genetic predisposition to ovarian, prostate, pancreatic, stomach and melanoma cancers.
Another important thing you should know is that everyone has BRCA 1 and BRCA 2 genes in their bodies, and that normal BRCA genes actually help you prevent cancer from occurring.
Gene mutation causes problems
Even though only about 10 percent of all cancers that occur is caused by a hereditary gene mutation, for people with a mutation in their BRCA 1 or BRCA 2 genes directly inherited from a parent, the lifetime risk of cancer significantly increases.
Women carrying a BRCA mutation, in fact, have up to a 50 to 87 percent lifetime chance of developing breast cancer versus the general population risk of 12 percent. And they have up to a 45 to 54 percent lifetime chance of developing ovarian cancer versus the general population risk of around 1.6 percent.
Importance of early detection
That’s why early detection is so important, said Jody Wallace, coordinator of clinical genetic services with St. Elizabeth Healthcare.
“Although it’s not a guarantee or an absolute, 100 percent risk that you’re going to get breast cancer if you inherit a BRCA mutation. Because the risks are so extravagant, we really do screen people more closely and give them options to reduce risk because their chances are more likely that they will get breast cancer at some point in their lifetime compared to the chances that they will not,” she said.
Should I get tested?
To determine if you should consider seeing a genetic counselor to have your risk assessed for a BRCA mutation, consider these:
- Is there a large prevalence of cancer in your family (on the same side of the family)?
- Among the cancers in your family, are they breast, ovarian, prostate, pancreatic, stomach or melanoma cancers? Those types of cancers are specific to a BRCA 1 or BRCA 2 gene mutation, their recurrence in multiple family members over multiple generations is concerning.
- Is there early onset disease in your family, or breast cancer that occurs before age 50?
- Does a male member of your family have breast cancer? As it’s so rare (a 6 percent lifetime risk for males with an inherited BRCA mutation versus a 0.1 percent lifetime risk for the general population), it’s a reason to become suspicious of an inherited mutation.
- Do any of your family members have a history of ovarian cancer?
How to get tested
If you think you’re a good candidate for BRCA testing, make an appointment with a genetic counselor to discuss the possibility of genetic testing. Genetic testing is ordered through a blood or saliva test. Results usually are available within two to three weeks, and most people pay $100 or less out of pocket for testing.
If your result is positive, meaning the test detected an inherited mutation, your genetic counselor will help you create a management plan, go over your options with you ““ including increased mammograms, the incorporation of breast MRI or preventive mastectomy surgery ““ and refer you to a physician or specialist to oversee your plan.
You also should remember that it’s a family affair. Your family members should consider being tested if your result is positive.
If your result is negative, that doesn’t necessarily mean that you or your family members are off the hook, Wallace cautioned.
“It still means there is cancer running in that family,” she said. “We just don’t know what the cause is.”
In that case, a genetic counselor would make specific recommendations for screenings based on the presentation of cancer within the family.
