Taking a Proactive Stance with Your Health
- A woman, 37, with a family history of cancer, lives by the mantra, don’t take life for granted. Her mom and dad passed away from breast and prostate cancer, respectively, by age 65. She inherited the BRCA gene mutation, which elevates her cancer risk. She’s since chosen prophylactic (preventative) double mastectomy and an expected hysterectomy to reduce her breast and ovarian cancer risk.
- A double mastectomy is a procedure that removes both breasts. Some women choose this procedure to reduce their risk of cancer, especially if they have a family history of cancer or possess the BRCA1 and BRCA2 gene mutation, which also increases their risk.
- BRCA comprises two genes, BRCA1 and BRCA2, which are tumor suppressors. When either of these genes is altered, damaged DNA cannot be adequately repaired, leading to an increased risk of breast and ovarian cancers.
- Several different genetic tests are available to determine if you have the BRCA1 or BRCA2 gene mutation.
Angela Linderman, 37, of Oregon, lives by the mantra, “Life is short, and it is not a guarantee.” Her philosophy is what motivated her to embark on a nearly year-long voyage around the world. However, adding fuel to her desires are her parent’s battles with cancer. Both of her parents passed away at the age of 65 after battling prostate and breast cancer, respectively. In the wake of her parent’s diagnoses, Linderman also learned she inherited the BRCA gene mutation, which elevates her cancer risk.
“My family’s genetics aren’t lining me up to let me have a terribly long life, so doing all the things I can now is kind of the motto,” Linderman said in a viral TikTok video.
Read More@angielinderman Ultimate World Cruise Q&A or really FAQ since i dont know how to do a Q&A on here. Help! I tried to andwer as many as I could that I know a lot of people have, but let me kniw what else you want to know about what its like on @Royal Caribbean’s Ultiamte World Cruise. #RoyalCaribbean #crusing #explore #solotravler #worldCruise #UltimateWorldCruise #UWC #SerenadeOfTheSeas #cruise #travel #solofemaletraveler #cruiseship #cruisetok ♬ original sound – Angie
WATCH: Reducing Your Risk for Ovarian Cancer
“Life is short, and it is not a guarantee to any of us that we will see old age. So, I’m just very much trying to do all the things that I can do now while I’m here,” Linderman said.
Helping Patients Understand Preventative Options When Faced with Potential Cancer Risk
What Goes into Deciding to Get a Mastectomy?
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
WATCH: What Happens During a Double Mastectomy
Other factors that weigh into the decision to get a mastectomy are the size and features of the tumor and your family history. However, the gravity of your decision comes into full view, especially if you choose to get a mastectomy and remove both of your breasts.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
Dr. Port added that most women do opt to have some reconstruction. The length of these surgeries can vary a great deal. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.
What Is the BRCA Gene Mutation?
BRCA is comprised of two genes: BRCA1 and BRCA2. Both BRCA1 and BRCA2 contain proteins that work as tumor suppressors.
They help repair damaged DNA and ensure the stability of each cell’s genetic material.
When either of these genes is altered, that mutation can mean its protein product does not function properly. The result of a nonfunctioning protein means damaged DNA may not be repaired correctly.
WATCH: Understanding BRCA Gene Mutation
BRCA1 and BRCA2 can increase the risk of female breast and ovarian cancers.
Several different genetic tests are available to determine if you have the BRCA1 or BRCA2 gene mutation. Hereditary genetic testing is usually done with a blood or saliva test.
If you discover that you do have a mutation, there are options available to manage your cancer risk, which include:
- Enhanced screenings
- Prophylactic (risk-reducing) surgery, which involves removing as much of the “at-risk” tissue as possible
- Chemoprevention, or the use of medicines to reduce the risk of cancer.
What to Consider When Weighing Preventive Mastectomy?
A prophylactic, or preventative, mastectomy is an operation where the breast tissue is removed to prevent cancer from developing in the future.
“Risk-reducing mastectomies are an operation where we take women at, usually, very high risk for getting breast cancer … for genetic mutation carriers, who are the ones at the highest risk; there’s unfortunately only one way to actually prevent breast cancer,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet.
“Women who are found to test positive for a genetic mutation really have two options,” Dr. Port explains. “One is what’s called high-risk surveillance, which means we check them every six months or so mammograms, MRIs with the hope that if God forbid, they develop breast cancer, we pick it up early. But that’s not prevention; that’s early detection.
“Early detection is a goal; it’s not a guarantee. For the woman who wants to be more proactive about actually preventing breast cancer, or as we say reducing her risk, unfortunately, the only way to do that is to remove the actual tissue at risk, and that is the breast tissue,” she adds.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
The benefits of a prophylactic or preventative surgery are:
- Significant reduction in cancer risk (from 80-90% to 1-2%)
- Nipples can often be spared
- Women can get reconstruction at the same time
Questions to Ask Your Doctor
If you’re facing the option of having a mastectomy, here are some questions to consider asking your doctor:
- What can I do to prepare for a double mastectomy?
- What happens before and after the procedure?
- For reconstruction, what are the benefits of using implants over my tissue and vice versa?
- What should I know about implants? Should I opt for preventative surgery?
- What will recovery look like after the procedure?
- What are the benefits of a watch & wait approach vs. preventative surgery?
- What kind of surveillance is required after the surgery?
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