When Angelina Jolie underwent her preventative double mastectomy earlier this year, she made women all around the country wonder if they should be tested to see if they were carriers of the BRCA gene.
But local experts say only a small percentage of women need to worry about getting tested. Also, there are things women can do to minimize their cancer risks, whether they test positive for the genes or not.
Dr. Mary Nicholson, medical director for the Women’s Diagnostic Center and section head for breast imaging in the Community Healthcare System, says women can do a few small things that will make a great deal of difference.
“Women can minimize their risk for all cancers, including breast cancer, by not smoking,” Dr. Nicholson says. “Maintaining a healthy body weight, particularly during and after menopause, is also important to breast cancer risk. Women that are overweight or obese have higher breast cancer risks.”
Dr. Nicholson says it is important to establish a regular exercise pattern and good eating habits.
Dr. Sasmita Misra, breast-interventional radiologist with Fransiscan St. Margaret Health, says most women only need to begin having mammograms at age 40 as well as having clinical breast exams.
“Those who don’t have a known family of risk factors only have a 12 percent risk of breast cancer,” she says.
There are any number of combinations that can make a woman fall into the “high-risk” category, Dr. Misra says. Among those factors include a family history of breast cancer or ovarian cancer.
Those women might consider having genetic testing because their risk can be about 60 percent.
“It’s very important to realize that not every woman with family members with breast cancer will carry this gene,” Dr. Misra says.
Dr. Misra says women who believe they are in the high-risk category should first talk with their doctor, and then meet with a genetics counselor.
“The genetic counselor will do a risk assessment to see if (testing) is necessary and to tell you the medical implications of the testing,” she says. “It’s never a good thing to just think that because so-and-so had breast cancer, you need to get tested.”
Dr. Janice Zunich is Director of the Genetics Center at Indiana University School of Medicine-Northwest and is a medical geneticist on staff at the Community Hospital High Risk Breast Clinic.
She says only about 5-7 percent of breast cancer has a heredity component. Dr. Zunich agreed that women should only be tested after reviewing the guidelines with a geneticist and after talking with their insurance companies.
“Another important aspect of the counseling process is to provide recommendations for screening and surveillance,” Dr. Zunich says. “Obviously, these recommendations are dependant on whether or not a mutation is identified in an individual. However, if the individual chooses to not be tested, or if the result of the testing is negative, such recommendations are very helpful in being able to present a means for the patient to be as healthy as possible.”
For women who go through the counseling and do want to get tested for the BRCA genes, it is important to first consult with your insurance company, Dr. Misra says.
“Testing is expensive, and can range from hundreds to thousands of dollars,” she says. “Insurance may, or may not, pay for it.”
Women who do get tested need to be prepared to deal with the results of the testing.
Women who test positive have a wide range of options, and might want to consider having their own daughters tested, Dr. Misra says.
Treatment options include surveillance, or closely monitoring the patient’s health with regular mammograms and breast MRI’s.
Other women decide to do the preemptive mastectomies, she says.
“The surgeries get rid of the breast to decrease the risk. The misconception is once you get the mastectomy, the risk disappears,” she says. “But there is a small, residual amount of breast tissue, and your risk is markedly decreased to about 5 percent.”
Regardless of whether they test positive or negative, Dr. Misra emphasized the importance of living a healthy lifestyle as a way to reduce risk.
“Physical activity and a good diet actually help decrease the risk of cancer, in general,” she says. “Try to keep a lifestyle that will be healthy. It might not change your future completely, but it might help a little bit.”