Gene Test, Preventive Surgery Save Women's Lives
Preventive Surgery Cuts Death Risk for Women With BRCA Cancer Genes
What It's Like to Get a Positive BRCA Test Result continued...
What's it like to find out you're carrying the BRCA mutation?
"I was offended. I thought, 'How could I lose my mother to cancer, how could I have these other medical challenges in my life, and then turn out to be BRCA positive as well?'"
Fortunately, Grossman's cousin -- a breast cancer survivor -- gave her the support she needed. Soon she was ready for the next step: considering preventive surgery.
As she'd already had all the children she wanted, it was not hard for Grossman to accept her doctors' adamant advice to have her ovaries and fallopian tubes removed. Deciding whether to keep her breasts was another matter.
Kaklamani notes that a woman in Grossman's situation has options. There are medications that reduce a woman's risk of breast cancer. And frequent screening -- alternating mammograms and MRI tests every six months -- is likely to catch cancers while they still can be cured.
But Kaklamani also notes that women with the BRCA gene are at high risk of aggressive, fast-growing breast cancer.
"If it were me, as I am an oncologist and have seen what advanced breast cancer looks like, I would elect for the procedure," she says. "But it is hard to tell women to undergo bilateral mastectomy when there are screening modalities that can find breast cancer when it can be cured. Most women will opt not to."
Grossman says that none of the doctors and very few of the family members she's consulted have urged her to keep her breasts. She intends to have the mastectomy.
"The real honest answer is that I don't like my breasts enough to be constantly monitoring for cancer," she says. "I have two small children. I lead a very busy life. I do not want to have chemo. And I do not value my breasts above all those other things."
Advice to Women Considering the BRCA Test
It's clear from the Rebbeck study that women can save their own lives by getting the BRCA test and, if they test positive, by having their ovaries and fallopian tubes removed.