Local Health Expert Explains BRCA Risks, Option

From the National Cancer Institute:

BRCA1 and BRCA2 are human genes that belong to a class of genes known as tumor suppressors.

In normal cells, BRCA1 and BRCA2 help ensure the stability of the cell’s genetic material (DNA) and help prevent uncontrolled cell growth. Mutation of these genes has been linked to the development of hereditary breast and ovarian cancer.

The names BRCA1 and BRCA2 stand for breast cancer susceptibility gene 1 and breast cancer susceptibility gene 2, respectively.

(WIBW) - Actress Angelina Jolie says a positive BRCA test spurred her to have her breasts removed.

What does that mean?

Ginger Reaves, APRN at the Stormont-Vail Cancer Center in Topeka, explains BRCA 1 and BRCA 2 are gene mutations that are hereditary. No matter which variation, Reaves says, the impact is the same - increased risk for several forms of cancer.

The increase is most striking when it comes to breast and ovarian cancers. While the general population has an eight percent risk of developing breast cancer, it's up to 87 percent for those with the mutation. Most people have a less than one percent risk for ovarian cancer - that climbs to 44 percent for those with the BRCA gene.

While those odds might have women racing to see if they're at risk, Reaves says not so fast. She says fewer than 10 percent of breast cancers are BRCA-related. When such a small percentage of population are carriers, she says it's not believed practical to test everyone.

Adding to the concern is that the screening test - conducted through a blood test or cheek swab - costs several thousand dollars. Reaves says insurance only covers it for those considered high risk.

Who should get tested? Reaves says anyone diagnosed with breast cancer before age 50, ovarian cancer diagnosis at any age, those who've had two primary breast cancers, male breast cancer, triple negative breast cancer, three or more family members who've had breast cancer diagnosed at any age, or those with two relatives who've had breast cancer if one of them was under the age of 50.

If the BRCA mutation is found, the most effective way to reduce breast cancer risk is what Jolie did - removing the breasts. Reaves says removing the breast tissue reduces the risk of developing breast cancer in the future 90 percent.

However, mastectomy is not the only option. Reaves says women also may opt for treatment with a drug such as Tamoxifen. It reduces risk 53 percent, though it also can have side effects like vaginal bleeding and blood clots. "Watchful waiting" can also be a viable options. It involves more mammograms and MRIs as frequent as every six months. Reaves says it won't prevent cancers, but will catch them early, which leads to more successful treatment.

Options are similar to reduce ovarian cancer risk - drug therapy versus removing the ovaries and uterus versus frequent ultrasound screening of the uterus and ovaries. Of those options, hysterectomy and oophorectomy reduce ovarian cancer risk up to 96 percent.

Reaves says women may consider factors like age and whether they want children in deciding their course of action. While Jolie has raised awareness by going public with her story, Reaves says no two women are alike.

Men also can have the BRCA mutation. esides breast and ovarian, it also increases risk for prostate and pancreatic cancers and male breast cancer. For prostate cancer, the risk goes from 13 percent in the general population to 20 percent for those with the mutation; for pancreatic cancer, it's less than one percent up to seven percent and for male breast cancer, it's .05 percent up to eight percent.

If you're concerned, talk to your doctor to see if you are a candidate for screening. The Jane C. Stormont Women's Center now offers a breast cancer risk assessment program to identify those who might be candidates for testing.


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