What Can You Do?

How do you know if you or the women in your family are at higher risk for breast or ovarian cancer? Mapping your cancer family tree is a smart first step. Why not use your next family gathering to learn your family’s cancer history?

Next, talk about your so-called cancer pedigree with your doctor. He or she can help you decide if you might need genetic counseling and testing.

Genetic testing requires less than a tablespoon of your blood. That blood sample shows whether you have a mutation in your BRCA1 or BRCA2 genes.

Still, the implications of this simple test aren’t quite so simple. For one, the results may upset you. What’s more, the testing may be costly. And not all health insurance plans cover it. Plus, the results may have implications for your future insurability.

That’s why genetic testing is only recommended for these women. These women have a higher-than-average chance of being a BRCA1 or BRCA2 gene mutation carrier.

  • A woman with two or more family members who had breast cancer before the age of 50
  • A woman with two or more family members who had ovarian cancer at an early age
  • A woman diagnosed with breast cancer at an early age
  • A woman diagnosed with ovarian cancer at any age

If genetic testing finds that you carry a BRCA mutation, you may want to take steps to reduce your risk of these cancers. You might want to do that even if the tests only show that you are at high risk for breast and ovarian cancer based on your family’s cancer history.

These are some recommendations to reduce the risk of breast cancer.

  • Chemoprevention by taking the drug tamoxifen
  • Preventive surgery to remove both breasts, called prophylactic bilateral mastectomy
  • Check-ups two times a year with a mammogram, MRI, or both

These are some recommendations to reduce the risk of ovarian cancer.

  • Chemoprevention by taking birth control pills
  • Preventive surgery to remove both ovaries, called prophylactic bilateral oophorectomy
  • Increased check-ups with a transvaginal ultrasound and CA125 blood testing

None of these screenings and prevention are 100% effective. That means you and your doctor must talk in detail about what you need. Make sure you bring up clinical trials. You may be able to participate in one. Or you might also talk with your doctor about high-risk clinics.

This article by the Gynecologic Cancer Foundation originally appeared in an advertising supplement to the Washington Post on Tuesday, May 7, 2002.