Breast Cancer Awareness Month, Part 2: I Tested Positive for BRCA. What Now?

Breast Cancer Awareness Month, Part 2: I Tested Positive for BRCA. What Now?

During Breast Cancer Awareness Month, Primary Care Associates of Texas is taking a closer look at the BRCA gene mutation that can cause breast cancer. In part 1 of our series ("What Is the Breast Cancer Gene?"), we explained what the gene is, and in the second and final installment of our blog series, we will explain how you can proactively manage your risk of developing breast cancer after testing positive for BRCA.

It’s natural to feel alarmed and frightened at this time. However, being forearmed with this information, your physician can develop a proactive medical treatment plan to better protect your health. The purpose of this treatment plan is to detect breast cancer earlier, so if you do develop the disease, it will be easier treat.

How to Manage Your Risk of Breast Cancer After Testing Positive for BRCA Mutations

You have several options to manage your breast cancer risk, including enhanced screening, risk-reducing surgery, and chemoprevention.

  • Enhanced screening: If you have the breast cancer gene mutation, you may choose to start screening for the disease at a younger age and/or be screened more frequently than other women who do not have this gene mutation. Some experts recommend women who carry this BRCA gene mutation undergo clinical breast examinations beginning as early as age 25, and to have a mammogram every year. This enhanced screening can detect breast cancer at an earlier age, when odds of successful treatment are higher. The American Cancer Society recommends women who have the BRCA gene mutation have annual screening with both mammography and MRI testing.
  • Prophylactic (risk-reducing) surgery: If you have high-risk BRCA mutations, you may opt for a preventative double mastectomy (the surgical removal of both breasts before cancer has developed and/or spread). This type of preventative surgery doesn’t eliminate the possibility of a breast cancer diagnosis in your lifetime, but it is does decrease the risk of developing breast cancer by about 90%.
  • Chemoprevention: This uses medicine to reduce the risk of getting breast cancer. Medications approved by the U.S. Food and Drug Administration (FDA) include tamoxifen and raloxifene, although their role in reducing the risk of breast cancer in women who have the gene mutation is still unclear. Medication may be the best option, though, for women who cannot or choose not to undergo preventative surgery.

I Have the Breast Cancer Gene, Can I Still Have Children?

The odds of a woman who has a BRCA gene mutation passing it along to her children, girls or boys, is 50%. This makes it extremely emotional for young women who have this genetic mutation if they wish to have biological children. It can even make a couple decide to forego parenthood, as they don’t want to worry about passing the BRCA gene mutation along to their sons or daughters.

Fortunately, there is good news: Through genetic diagnosis of your embryos, a process called Preimplantation Genetic Diagnosis (PGD), fertility doctors are now able to determine which embryos carry the abnormal BRCA gene, and then only transfer the unaffected embryos to the mother's uterus, which ensures she will not transmit the gene to her children.

I Have No Family History of Breast Cancer, Can I Still Get Breast Cancer?

Yes. It’s important to note that less than 10% of women diagnosed with breast cancer have a BRCA gene mutation, meaning 90% of those who are diagnosed with breast cancer do not have the breast cancer gene and most have no identifiable reason they developed breast cancer. Another important thing to note is the age of onset for breast cancer. If your mother, sister, grandmother, or aunt developed breast cancer post-menopause, this usually indicates the breast cancer was not genetically inherited and you are likely not a carrier of the BRCA gene mutation.

To discuss breast cancer with a board-certified family physician at Primary Care Associates of Texas, please contact us at (817) 725-7880.

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