How Family History Can Guide Your Cancer Prevention Efforts
Country singer Morgan Wade, 30, underwent a preventative double mastectomy after discovering she carries the RAD51D gene mutation, a high-risk marker for breast and ovarian cancer.
Her decision was shaped by a strong family history of cancer—her aunt and mother both tested positive for RAD51D and took proactive steps, including mastectomies and ovary removal.
Wade shared her journey in a candid Instagram video, encouraging others to pursue genetic testing and emphasizing the importance of knowing your family’s medical history.
Now preparing for egg retrieval and a future hysterectomy, Wade says she has no regrets and hopes her openness empowers others to take charge of their health and longevity.
The genetic test may involve a simple blood test, saliva sample, or tissue collected through a biopsy. Test results may also influence possible treatment.
The results help your care team determine if you have a specific mutation that puts you at higher risk for cancer. The results help doctors tailor treatment and are helpful for breast cancer patients.
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.
Country music singer Morgan Wade, 30, is known for her raw candor, and in a recent Instagram video, she brought that same vulnerability to a deeply personal health decision. Wade shared with fans why she chose to undergo a preventative double mastectomy after learning she carries the RAD51D gene mutation, a lesser-known but high-risk genetic marker linked to breast and ovarian cancer.
“You don’t know that you’ll 100% get cancer,” Wade said in the video, “but if I can take these preventative measures, why would I not?”
The RAD51D mutation, similar to the more widely known BRCA gene mutations, significantly increases the likelihood of developing certain cancers.
WATCH: How Testing For BRCA In Breast Cancer Works
Wade’s decision was shaped by her family’s experience: her aunt Leslie was diagnosed with breast cancer at age 30 and later discovered she carried the RAD51D gene. She chose to have a hysterectomy and her ovaries removed as a preventative measure. Wade’s mother followed suit after testing positive for the same mutation, undergoing both a double mastectomy and ovary removal. During her surgery, doctors discovered cancerous tissue.
“My mom told me, ‘You should get tested,’” Wade explained.
“I travel a lot, and I’m not really home, and I used that as an excuse, but it was easy enough that even I could do it. They mailed me the tube, I spit in it, and I sent it in. Then, I found out that I had the gene as well,” Wade said.
In November 2023, Wade underwent a double mastectomy and reconstruction.
WATCH: The Promise of Restoring Sensation After Mastectomy
“I’m super glad that I did that and have no regrets at all,” Wade said.
Her next steps include egg retrieval, followed by a hysterectomy and ovary removal.
A hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix, according to the National Cancer Institute. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy.
In a previous interview with SurvivorNet, Dr. Heidi Gray, a gynecologic oncologist, talked about open surgery versus robotic surgery and how the two can be used to perform a hysterectomy.
“The most common procedure that we do robotically would be a hysterectomy, removal of the tubes and ovaries, you can also do more complicated omentectomy, removing the omentum [a fatty apron surrounding abdominal organs],” Dr. Gray explained.
“Eventually, I’ll have to use a surrogate,” she added, acknowledging the emotional complexity of preserving fertility while protecting her health.
Since sharing her story, Wade says she’s received messages from fans who’ve pursued genetic testing themselves. “I think it’s important to know,” she said.
WATCH: Considering Genetic Testing? Talk to Family if You Can
Genetic testing can empower people with important information, and knowing your family medical history can play a big role in determining if it’s necessary. “Asking questions about what might be going on with your aunts, your uncles, your cousins, your grandparents … that’s going to make it a much easier process for your genetic counselor and your physician,” Rachel Webster, a genetic counselor at MD Anderson Cancer Center, tells SurvivorNet.
If you know you have a family history of cancer, learn as much as you can about it, Webster added.
Morgan Wade performs onstage during Day 2 of the 2023 Stagecoach Festival on April 29, 2023, in Indio, California (Photo by Monica Schipper/Getty Images for Stagecoach)
“I would not have known had it not been for my aunt, my mother, and my cousin. Everyone in my family is doing this [genetic testing], and I’m so grateful that I did it. I have that knowledge now, and I can do everything in my power to take care of myself to try to live a long and healthy life.”
Wade’s openness is helping demystify preventative care and genetic testing—especially for young women navigating family history and future planning. Her message is clear: knowledge is power, and taking action is a form of self-love.
Genetic testing for cancer is typically conducted in a medical setting, such as a primary care office or an OB-GYN clinic. However, some tests are now available for direct purchase, allowing individuals to explore their genetic risk independently.
Initially, genetic testing was recommended for a limited group of individuals based on specific risk factors, including a strong family history of breast cancer, personal cancer history, or certain ethnic backgrounds.
WATCH: Helping you understand genetic testing.
“It started out with a very narrow field of women and men who were recommended to have it based on certain risk factors, family history of breast cancer, or other cancers, and also ethnic backgrounds,” explains Dr. Elisa Port, a surgical oncologist at Mount Sinai, in an interview with SurvivorNet.
Guidelines from the National Comprehensive Cancer Network (NCCN) suggest that genetic testing should be prioritized for patients at higher risk for hereditary breast cancer. This includes individuals diagnosed with breast cancer before the age of 45, those with a strong familial history of the disease, and individuals of Ashkenazi Jewish descent.
Meanwhile, the American Society of Breast Surgeons (ASBrS) takes a broader approach, recommending genetic testing for all patients diagnosed with breast cancer.
These evolving recommendations reflect a growing emphasis on personalized medicine, ensuring that individuals at risk receive appropriate screening and guidance to manage their health proactively.
What If You Have the BRCA Gene Mutation?
Discovering a genetic mutation can be unsettling, but there are several options available to manage cancer risk effectively. These include enhanced screenings for early detection, prophylactic (risk-reducing) surgery to remove high-risk tissue, and chemoprevention—the use of medications designed to lower the chances of developing cancer.
Interestingly, for individuals diagnosed with ovarian cancer, carrying a BRCA mutation may provide a treatment advantage when paired with a class of drugs known as PARP inhibitors. Approved by the FDA starting in 2014, these targeted therapies have transformed the landscape of ovarian cancer treatment.
WATCH: Understanding the BRCA Gene Mutation
PARP inhibitors function by blocking the protein PARP, which normally repairs damaged DNA. By preventing this repair process, the inhibitors selectively destroy cancerous cells while sparing healthy ones, making them a powerful treatment tool.
“The PARP inhibitor prevents the repair of the [damaged] single-strand DNA break, and your BRCA mutation prevents the repair of the double-strand DNA break,” explainsDr. Rebecca Arend, Associate Scientist at the University of Alabama, Birmingham, in an interview with SurvivorNet.
This combination of genetic insight and advanced medical therapies highlights how precision medicine continues to evolve, offering more effective, tailored approaches to cancer prevention and treatment.
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.
WATCH: What to Consider When Thinking About a Mastectomy
“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; it’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 own 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?
