A few weeks ago, a long-standing patient of mine gave me her family history – her mother had died from ovarian cancer. According to the published guidelines, Judy qualified for testing for HBOC (Hereditary Breast and Ovarian Cancer Syndrome). BRCAI and BRCAII are the specific genes that can carry the mutation, which can dramatically increase an individuals risk for breast and ovarian cancer. Statistically, now that Judy is a carrier for this gene mutation, she has up to a 50% chance of getting breast cancer by age 50, and up to 44% chance of developing ovarian cancer by age 70. Judy’s children, sisters, and brothers have a 50% chance of being BRCA positive. This is scary but at the same time exciting information for Judy. Armed with this information, she now has been empowered to be proactive, take charge of her life and beat the odds if she proceeds with risk reducing surgery to prevent breast and ovarian cancer – truly amazing and wonderful! Without the knowledge of HBOC syndrome or the desire and inclination, most gynecologists could have easily overlooked or not even bothered to question Judy about her important family history and explain to her the benefits of a simple blood test. Most insurance companies will either cover a portion or all of the cost if she qualifies by well established guidelines.
There are other options available other than surgery for younger patients who have been identified with a positive BRCA mutation. This may include ongoing surveillance with yearly mammograms and breast MRI for early detection; also pelvic ultrasounds and serum tumor markers are available that can screen for ovarian cancer before any signs and symptoms develop. If your family history has several relatives with breast, ovarian, uterine, or colon cancer, let your gynecologist be aware and ask to be tested if you qualify. Knowledge is power and you can live a long healthy life with whatever medical or surgical options you choose. Don’t bury your head in the sand – what you don’t know can lead you to unnecessary suffering expense and misery for you and your loved ones.
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