BREAST CANCER and BRCA Testing

October is Breast Cancer Awareness Month, so I wanted to take a moment to talk with you about screenings – what they are, who should have them, and what to do based on your results.

What are screenings – are they different from a mammogram?

Screenings and mammograms are very different. Mammograms detect masses in breast tissue that should be investigated. Screenings actually look at genes to determine if someone has a higher risk of developing disease.

How the screenings work

Screenings look for specific genetic defects called BRCA genes (BR for breast; CA for cancer). Discovered as recently as 1994-95, they’ve become a standard of diagnosis in the last 20+ years. The medical community has long suspected that cancer occurs in families or communities that share genetic traits – for example, Ashkenazi and Sephardic Jews carrying the BRCA gene have a 2 percent higher risk of developing breast cancer. The discovery of BRCA genes provided solid evidence of shared genetic risk. BRCA1 and BRCA2 are “tumor-suppressor genes.” Their role in the body is to provide instructions to the immune system to repair damage and prevent cancer. However, when BRCA1 or BRCA2 are mutated, they are not able to fix DNA breaks, resulting in a potential for increased risk of cancer. Generally, screenings are done to detect an increased risk of breast or ovarian cancer, but these genes are also involved with prostate, melanoma, and pancreatic cancers. Men with BRCA1 and BRCA2 have a higher risk of early-onset prostate cancer, developing the disease before age 65.

Are screenings effective?

They are effective in determining if you have an elevated risk of cancer, but it’s important to note that having a BRCA gene does not necessarily mean you will develop cancer. However, since a woman with an inherited BRCA1 or BRCA2 mutation has a 50-85 percent chance of developing breast cancer over her lifetime, compared to a 12 percent risk in the average woman, it’s a decision for you to make, if you would like to have this knowledg. Equally, approximately 15 percent of all ovarian cancers are thought to be caused by an inherited genetic mutation. A woman who has a mutation in BRCA1 has a 40 percent chance of developing ovarian cancer in her lifetime. If cancer runs in your family, undergoing genetic screening provides you information for a more complete understanding of your risk.

Why test? Knowledge is power.

Twenty years ago, the BRCA genetic test was expensive and not readily available. Fortunately, we’ve come a long way: testing is easy to obtain and often covered by your insurance carrier. You can even test for this gene online! However, if you have a history of breast cancer in your family, I recommend you be tested by a medical facility that provides genetic counseling. There are implications to be considered if the test comes out positive.

What happens if I test positive?

Remember, a positive test result doesn’t mean you’re guaranteed to develop the disease. This is an opportunity to be proactive about your health and lifestyle choices. “Proactive” means getting checked more often to increase the chance of early detection if the disease does appear. For example, if a young woman has breast cancer in her family, and she tests positive for the BRCA gene, it’s recommended she have breast MRIs every year starting at the age of 25, and a mammogram every six months. Ovarian screenings begin when women are between 30 and 35 years of age. For a woman who tests positive for the BRCA1 gene, she may have some further decisions to make. Because ovarian cancer often originates in the fallopian tubes, she may opt to have them removed. She may also want to consider options to preserve her fertility, such as freezing eggs or embryos. Any woman who tests positive in an ovarian screening should schedule a conversation with a gynecological oncologist. Early removal of a woman’s ovaries impacts her entire body, and a GO can help her understand her options for fertility preservation as well as implications for heart and bone health, potential impacts on her lifestyle, and intimacy concerns.

The power of integrative care

As a provider of supportive cancer care, the more information we have about the inner environment of your body, the better we are able to orient your Eclectic Triphasic Medical System (ETMS) protocol to address your body’s metabolic needs. ETMS looks at the “landscape” of the cancer so we can better understand its causes and how to best to proceed. We’ll assess the inner environment of the “host” or the person with cancer.

• The microenvironment of the tumor: tests such as CARIS, Cancer Genetics and Weisenthal, among others, provide detailed and exact information on the driving forces creating the tumor or cancer.
• The characteristics of the tumor: knowing this gives us considerable insight into how best to target the disease.
• The exogenous environment: what toxic chemicals or environments has the host been exposed to?

Proactive steps for breast health

No matter what we may think our risk is of developing breast cancer, there’s no way to know for sure; it makes sense to do what you can to decrease your risk. And bonus: all the things we can do to promote better breast health are also really good for our overall health!