In 2013, Angelina Jolie announced that she had undergone a double mastectomy and reconstructive surgery as a way of minimizing her risk of developing breast cancer and ovarian cancer. She generously shared her story with the public, explaining that her mother had died of breast cancer at the age of 56; that she, Angelina, had inherited a “faulty” BRCA-1 gene; and that her doctors said she had a very high risk of developing breast cancer (about 87%).
The news, though shocking, focused our attention on the subject of BRCA gene mutation and its strong correlation with cancers in women. By sharing her story she offered each of us an excellent opportunity to reflect upon our own health situation and options.
One test that can help identify a women’s risk of developing breast cancer is the Estrogen-Metabolism Assessment. It evaluates how well your body metabolizes and processes estrogen. Certain types of estrogen metabolites can increase one’s risk of developing breast cancer and worsen your prognosis if you do develop cancer. By proactively measuring the levels of these metabolites in a person’s blood or urine, we can determine whether medication changes or lifestyle modifications, such as diet and exercise, are warranted. This is a test that can be ordered through the Kaplan Center so that you can discuss the results with your physician.
There are many other things that you do to improve your health and lower your cancer risks – such as reducing your stress level, getting sufficient exercise, sleep and balanced nutrition, including the nutritional supplementation that you may need. These factors are explained in more detail in this article about the steps you can take to improve your breast health. I encourage you to review it and forward it to a loved one.
If you have a strong history of breast cancer in your immediate family (mother, grandmother, sisters, etc.) and are concerned about your own genetic risk of developing breast or ovarian cancer, you may want to seek genetic counseling with a specialist. Coming to this decision is a journey often fraught with emotion for patients and their partners; consequently, I usually recommend patients who may want to pursue genetic testing to the Inova Breast Care Institute. According to Inova’s guidelines, the women who can benefit from genetic counseling for breast cancer will have one or more of the following characteristics:
- Strong family history of early-onset breast cancer, diagnosed before age 50
- Breast cancer in two or more first-degree relatives on the same side of the family
- Multiple primary tumors (for example, a woman with two primary breast cancers)
- Bilateral or multiple cancers
- Ashkenazi (Eastern European) Jewish ancestry with significant personal and/or family history of breast or ovarian cancer
BRCA-Gene Testing, which is conducted at Inova, can identify gene mutations that indicate an increased risk of developing certain breast and ovarian cancers. On average, women who have inherited the harmful BRCA-gene mutation have a 65 percent higher chance of developing breast cancer during their lifetimes than women without it. Knowing whether or not you carry the mutation can help you understand your personal risk of developing breast or ovarian cancer.
After prevention, detection is the next most powerful step in fighting breast cancer. Women now have access to 3-D Mammography, a new technology that allows radiologists to view the tissue inside the breast layer by layer and from different angles. Although the 3-D mammography takes a little longer than an ordinary mammography (approximately 4 seconds longer per compression), it is much more accurate in detecting breast cancer.
Most importantly, I urge you to not shy away from facing up to what can be emotionally difficult health topics. Take charge of your health. Talk with your doctor about the medical testing and lifestyle changes that can help you increase your chances of living a long, healthy life!