I would have to reshuffle my close friends to get to that statistic, because its more like four in twelve, and not in our eighties but sixties. For a time it looked as if breast cancer was everywhere. Of course its one of the top diagnosis that I see in practice and since there are over 10 million breast cancer survivors (perhaps you!) many breakthroughs for all types of cancer are developed by researching this group.
Our awareness is no longer for ourselves. Everyone of us as parents and grandparents would take on any threat if it meant keeping the “children” safe. The statistic is thankfully much lower in those age groups. However, we are beginning to witness some of the next generation getting biopsies, breast MRI’s, prophylactic mastectomies, once again, we don’t need October for awareness. When Casey DeSantis revealed her diagnosis this week at tender 41, mother of three toddlers and first Lady of Florida, we gasped, internalizing the impact of this disease on our own loved ones.
While statistics say 85% of breast cancers are not inherited, I believe we haven’t full knowledge. BRCA 1 and 2 genes and Ashkenazi Jewish have very high risk, there surely are other genes hidden on those tiny alleles just waiting for a combination of factors to burst forth. Therefore, I have a few recommendations and websites for guidance today.
If you have a family history (both mother and father side) of cancer, especially pre menopausal breast and prostate in 50’s, consider genetic testing (preceded by genetic counseling because information is not without impact). If you have several close first and second degree relatives with cancers, genetic tests can ameliorate your concerns or raise awareness for close surveillance. Every time you go to the doctor, they ask your family history- this is why. Diseases run in families including cancers. if you have minimal cancer history, then you can follow the government guidelines for screening ( mammograms, prostate exams, colonoscopies, skin screenings…..all the minimum to do).
New blood biopsies are coming (but that finds cancers already present). Genetic testing for several genes- some panels up to 48, will direct your doctor to pay greater attention to your individual risks. For example, if you have a family history of gastric cancer, we won’t prescribe reflux drugs without doing an upper endoscopy or if your father had prostate cancer in his fifties or sixties, then checking psa’s in men as young as 40-50 becomes a part of the yearly physical. All very tailored to you. Healthcare has changed and becoming lifelong, not just after medicare age. There are opportunities for intervention along the way. We are seeing more women having bilateral mastectomies when they are tested and found at high risk to avoid, not treat, a breast cancer (like Angelina Jolie).
Eventually, genetic testing will accompany your physical exam, but you do not need to wait- if you have the history, insurers now cover these evaluations. It is an opportunity for greater awareness for those who want heightened vigilance. You can ask your primary care or friendly oncologist. If you have had cancer, ask them about your children’s risk. Let’s keep the power, look the devil in the eye unafraid and come up with a plan right for you and your family.
Helpful websites:
Breast cancer risk assessment tool, NCI: (brrisktool.cancer.gov) breastcancer.org.…………….cdc.gov breast cancer genome.gov …………………...genetic testing NIH cdc.gov>breast>ovariancancer