The New York Times recently published a front page article about the Breast Cancer Gene and the dilemma many women have about testing for the Breast Cancer Gene. Angelina Jolie tested positive for a Breast Cancer Gene mutation and elected to have both of her breasts removed.
What is the Breast Cancer Gene? And why is there a dilemma?
Genes are the architectural blueprints for our bodies and are made of DNA. The BRCA (Breast Cancer) gene is the gene blueprint for a molecule that fixes bad DNA. Bad DNA can lead to cancer. BRCA genes are tumor suppressor genes which are genes that normally suppress cancer from developing. However, if the BRCA gene does not work, i.e. if the BRCA gene is mutated, then bad DNA may not get repaired and cancer can develop. Women who have a mutated BRCA gene are at increased risk for developing Breast Cancer and Ovarian Cancer. Hence, Angelina Jolie had both of her breasts removed, a procedure called a Double Mastectomy. She has plans to remove both of her ovaries in the near future.
The BRCA gene, like all genes, are passed down from parent to child. A child whose mother or father has the mutated Breast Cancer Gene has a 1 in 2 chance of also having the mutated Breast Cancer Gene. The dilemma is twofold: does a woman with Breast or Ovarian Cancer want to know if she has the Breast Cancer Gene mutation? And if she does have the BRCA mutation, does she want her children to know if they carry the BRCA mutation? If you had the BRCA mutation, would you have both of your breasts removed? If you were 60, perhaps yes? If you were 50? If you were 40? If you were 30? If you were 25? And when would you have your ovaries removed? Would you forgo becoming pregnant? Would you risk ovarian cancer so that you could become pregnant? Would you want to know?
These are very important questions and why someone considering these issues should speak with a physician, nurse practitioner or genetic counselor trained and experienced in counseling individuals about the genetic risk for cancer.
Knowledge about the Breast Cancer Gene can help us live full, productive and healthy lives, if we know how to use the information. BRCA counseling can help us work through, and ultimately, solve our dilemmas, just as Angelina Jolie did.