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A SURVIVOR'S STORY

4/2/2007

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by Anonymous

I just celebrated my 53rd birthday, my sister her 59th , and my mother just celebrated her 85th. We’re all bilateral breast cancer survivors. My mother was diagnosed at age 36 on one side, and at age 46 on the other. I was diagnosed at age 32 on the right side and then again two years later, on the left. When I was just 32, I felt a lump in an area just a little above my breast, so it didn’t register at first that it might be breast cancer. I was expecting to have to deal with breast cancer at some point in my life because of family history, but this lump wasn’t really in my breast, I thought.

​A few months passed and then it began to bother me so I had it checked out. After several exams and a biopsy I learned that it was breast cancer. I had a modified radical mastectomy with good results. No lymph nodes were involved and the doctor decided surgery would be sufficient, and no chemo or radiation would be needed. Two years later I repeated the scenario – this time the cancer was discovered on my mammogram. The story of my diagnosis and treatment was pretty textbook for the time – 20 years ago.

Reflections
There are many more women out there who have been through this than you realize.
At first, I felt very alone. At 32, there were few others my age that had breast cancer. I was active in the YMCA but was uncomfortable in the locker room. This was merely my self-consciousness; the other women got comfortable with my appearance quickly and were completely supportive. Now, I’m amazed at how often I find women (and men with wives, sisters, mothers) who have also been touched by this disease. And many are survivors.

​There’s nothing like a positive attitude! I think breast cancer gave me a new appreciation for what a gift every day is. Through the recovery process I found out how many friends I had and was overwhelmed with their caring and generosity. Everyday I am grateful for my wonderful husband; always loving and understanding and never once expressed disappointment in my changed body.

Never underestimate the value of denial! After my surgeries I did everything to get back to “normal”. Diet, exercise, work, play. I want to give and get the most out of every day so that no matter what happens, I can feel I had a life well-lived. There is no point in worrying about what the future may bring. And worrying is what I deny myself.

Every woman has to decide for herself whether a support group will help her. I tried attending a support group, but stopped because I just didn’t want to talk about cancer so much. Some women with advanced cancers didn’t survive and it was too hard for me to deal with. I didn’t feel a support group was helping me deal with my situation and I didn’t feel strong enough to participate just to try and help others. This may sound cold, but I had a “denial” strategy that didn’t fit in with support groups.

I always regarded breast cancer as a survivable disease. This is probably the most important attitude I have. Sure, I know lots of women haven’t survived but I know lots more who have. I received the gift of this attitude from my mother who was already a survivor at the time of my diagnosis. I think every woman, when faced with a breast cancer diagnosis, has to confront the fear that she may die. But once I confronted that, it helped for me to just regard it as a “bump in the road”.

Find a primary physician who understands breast cancer. I have a doctor right now who understands the risks of cancer recurrence in other parts of my body and screens for these. It provides me with peace of mind that we are doing all we can do.

Hope for the Future
My mother has breast cancer again – discovered 40 years after her last occurrence. I have hope because there are so many new drug therapies now. I get strength from her courage and she keeps a good perspective. She may get the remission we are all hoping for or she may not. Regardless, she is happy for the many good years she has had and she focuses on her love for Dad and us. This may happen to me too, as it may happen to any of us. I will try to deal with whatever happens with the quiet grace and acceptance that my mother is teaching me now. 
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GENETIC TESTING FOR BREAST CANCER

4/1/2007

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Picture
By Joginder Singh, M.D.

Breast Cancer is a common cancer. One in 9 women will have breast cancer in their lifetime. Most women are scared of the hereditary nature of breast cancer. They would like to know the chances of breast cancer in their siblings and children. It should be noted that most breast cancers are sporadic and no hereditary cause is found. Only 7-10% of breast cancers are due to hereditary factors. Major causes of hereditary breast cancer are due to alterations of genes BRCA1 and BRCA2.

What are BRCA1 and BRCA2 mutation?
Every human cell (except red blood cells) has a nucleus, which has 23 pairs of chromosomes. Chromosomes contain DNA (Deoxyribonucleic acid). DNA exists as two long paired strands spiraled into a double helix. Each strand is made up of millions of chemical building blocks called bases. There are only four different chemical bases in DNA (Adenine, Thymine, Cytosine, Guanine) but they can be arranged and rearranged in countless ways. The order in which bases occur determine the message to be conveyed much as specific letters of the alphabet combine to form words and sentences. Cell function is determined by protein and structure of proteins and function depends on structure of DNA. If there is mutation or change in normal base pair sequence in DNA proteins formed may not function or function differently. It should be noted, that some mutations are silent. Like the words GRAY and GREY are different but mean the same. However, if you change GRAY and GREY to GRZY, it does not mean anything and the protein may not function. BRCA is located on chromosome 17 and BRCA2 is located on chromosome 13. 500 different mutations have been found in BRCA1 and 300 in BRCA2, however, many mutations are silent and some are of unknown significance.

Who should be tested?
​Because these tests have implications not only on the individual being tested but also on the whole family, the individual being tested should be given detailed information about the risks and benefits of testing.

Features that increase likelihood of having BRCA mutation are:
1. Multiple cases of early onset breast cancer.
2. History of ovarian cancer in same family.
3. Breast and ovarian cancer in
4. same woman.
5. History of bilateral breast cancer.
6. Ashkanezi Jewish heritage since there is a higher incidence of a particular mutation in those families.
7. Male breast cancer.

Pattern of Inheritance
These mutations are transmitted by autosomal dominant inheritance, which means that they are transmitted equally by males and females. 50% of offspring’s of affected persons will carry the mutation; it does not depend on sex. It is a very common misunderstanding among patients that inheritance only comes from mother, whereas fathers transmit genes equally.

What can be done if BRCA mutation is found?
1. Monthly breast examinations starting at the age of 18.
2. Clinical exam every 6 months beginning at age 25.
3. Mammograms and MRI of breast beginning at age 25 or individualized depending on the age of the youngest relative with cancer. MRI is more sensitive than mammograms in mutation carriers.
4. Prophylactic mastectomy decreases risk of breast cancer by more than 90%.
5. Prophylactic oophorectomy (removal of ovaries) after childbearing age decreases risk of both breast and ovary cancer.
6. Tamoxifen or Raloxifene considered chemoprevention could be considered.

Benefits of gene testing:
1. Gives relief when tests are negative.
2. Intervention can be done to prevent cancer if results are positive.
3. Informed decisions and fewer check ups.

Limitations of testing:
1. Psychological distress if positive.
2. Some mutations may never lead to cancer, but give distress because we may never know the meaning of such variation such as GRAY and GREY words.
3. Insurance issues even though there are laws against insurance discrimination.

The decision to undergo testing should be personal and voluntary. These tests should not be done to please relatives, friends, children, siblings, or health care providers.


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  • Home
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  • Support
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    • Ignite the Cancer Conversation
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    • National Breast Cancer Coalition
    • Iowa Stop Breast Cancer
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    • Access to Care
  • Join Us
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    • Volunteer
    • Events >
      • 16th Annual Pink Ribbon Run
    • Membership
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