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    I'm Too Young to Get Breast Cancer!

    At 31, she learned she'd inherited the "family disease"—and then Tomomi Arikawa found an amazing way to fight it


    For the biopsy, the radiologist used a needle to extract five tissue samples. Afterward, she tried to reassure Tomomi, telling her how treatable it would be if it was "something," but the words just floated around the room. Then a nurse brought Keiko in, "with a look on her face I'd never seen before: extreme worry and guilt and fear," recalls Tomomi. "That was the beginning of it — I don't think she smiled again for two months." The next day, when they learned that the tumor was definitely malignant, was even tougher. At roughly two centimeters (about the size of a grape), the cancer pressed against her skin — that was the sore spot Tomomi could feel.

    Breast cancer strikes about 200,000 U.S. women each year, but fewer than 7% are under 40. And only 5% to 10% of new cases are linked to a family history similar to Tomomi's. But it's not surprising that Keiko and later Tomomi tested negative for the BRCA1 (breast cancer susceptibility gene 1) and BRCA2 mutations, which give women up to an 80% lifetime risk of developing breast cancer. (Shizuka, never tested, died of Alzheimer's disease in 2008.) The mutations are rare, affecting only one in 1,000 women, and rarer still among Japanese Americans like the Arikawas. Indeed, breast cancer rates generally are lower in Asian Americans than in other ethnic groups.

    Yet breast surgeons see families like Tomomi's all the time — one member after another stricken with the disease, but negative on genetic tests, suggesting that other, still undiscovered, genetic factors are at work. "When BRCA1 and BRCA2 were identified more than 15 years ago, we thought it would open the floodgates for BRCA3 and BRCA4 and so forth," says Tomomi's surgeon, Elisa R. Port, M.D., codirector of the Dubin Breast Center at the Mount Sinai Medical Center in New York City. "But that hasn't happened."

    The lack of a known breast cancer gene doesn't mean the disease isn't genetic, however. "Probably in someone like Tomomi, there's an accumulation of different genetic mutations. We just can't test for them yet," Dr. Port explains.

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