If you've found out that you have a BRCA gene change, you may be feeling pretty overwhelmed. But when it comes to cancer, knowledge is power. Now that you know you are BRCA-positive, you can take steps to reduce your risk of breast and ovarian cancer.
Experts know that women who are BRCA-positive are more likely than average women to get breast cancer and ovarian cancer. This table shows the predicted number of women in each group who will get cancer by age 70.
It's clear that having a BRCA change makes a big difference. But it's important to realize that:
The problem is that no one can predict who will or won't get cancer or when. That's why experts suggest that all women with BRCA changes take steps to prevent cancer.
To help women with BRCA changes, some experts did a study that let them predict how much breast and ovarian cancer risk could be reduced by:
The study also looked at having the surgeries at different ages. So for example, you can see what difference it might make if you keep your breasts and ovaries until after you are done having children. These results are one piece of information you can use as you can explore how to lower your cancer risk.
Surgery and screening tests are not your only choices. You can also talk to your doctor about preventive medicines such as tamoxifen. And some women choose to have no treatment or extra screening.
According to the study, here's how the different prevention methods affect the life spans of women with BRCA1 changes.
According to the study, here's how the different prevention methods affect the life spans of women with BRCA2 changes.
Take some time to think about your options. A genetic counselor can help you understand how the prevention options affect your cancer risk. Discuss them with your family and close friends. Then you can reach a decision that feels right for you.
U.S. Preventive Services Task Force (2005). Genetic
risk assessment and BRCA mutation testing for breast and ovarian cancer
susceptibility: Recommendation statement. Annals of Internal Medicine, 143(5): 355–361.
Kurian AW, et al. (2010). Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers. Journal of Clinical Oncology, 28(2): 222–231.
Also available online: http://jco.ascopubs.org/content/28/2/222.full.
Other Works Consulted
Domchek SM, et al. (2010). Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA, 304(9): 967–975.
Also available online: http://jama.jamanetwork.com/article.aspx?articleid=186510.
National Cancer Institute (2011). Genetics of Breast and Ovarian Cancer (PDQ)—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/healthprofessional.
June 28, 2013
Sarah Marshall, MD - Family Medicine
& Douglas A. Stewart, MD - Medical Oncology
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