BRCA Basics: Genetics, Risks and Risk Management
In this session, Dr. Rona Cheifetz goes over the basics of genetics, known cancer risks associated with BRCA mutations, how one goes about getting tested, and how lifestyle factors influence cancer risk.
Q&A with Dr. Rona Cheifetz
How would I go about freezing my eggs if I wanted to? I will be 29 in December with the BRCA1 gene. I'm assuming that you should do that earlier than later? Also, do I have someone I can ask about that, being BRCA1 gene positive? Thank you!
Egg freezing is done at fertility clinics. They would be able to best advise your regarding when you should do it, but generally the optimum age is in your late 20s. You can be referred to a fertility clinic by your doctor to discuss this.
Is there research about removing the prostate before a cancer diagnosis to reduce risk?
There a recent proposal in the literature about doing a study of prophylactic prostate removal, but I am not aware of any current trial. There are potential long term complications of this surgery, like incontinence and impotence such that researchers would like to find an alternative approach to screening preferably, such as prostate MRI. This is being researched.
If I have had breast cancer already on both sides 10 years apart, what do you think my risk of a reoccurrence is in the future?
It isn’t possible to answer this question as it depends on what type of cancer you had, what surgery you had and what other medical treatment you received. Your cancer specialist would be better able to answer this.
When can a daughter of a BRCA1 carrier get the genetic test in BC (age 18)?
Genetic testing would be available at age 19.
My mom died from ovarian cancer, my grandpa died from pancreatic cancer. I have the BRCA1 mutation. I have had multiple surgeries NOT related to this part of my life, but I was considering the ovary/breast, fallopian surgical option, but what is the risk/benefit of this vs. Tamoxifen in someone with a strong medical history?
This is hard to answer without knowing what your health issues are, but importantly, only by removing your tubes and ovaries can you reduce your risk of ovarian cancer. If you took the birth control pill for more than 5 years that will have reduced your risk in half but it is still very high. Tamoxifen doesn’t reduce ovarian cancer risk. So, even though you have had other surgeries we would generally still recommend removal of your tubes and ovaries, assuming it can be done.
Tamoxifen reduces breast cancer risk by 50%, so that would be an option if you can take it to reduce your risk if you did not want to have mastectomies. I would not assume that you would necessarily react to a medication the same way that your mother did, and if you could not tolerate the medication, you could always stop it. Mastectomies though would reduce your risk of getting breast cancer by 90%.
When you talk about new diabetes, do you mean type 2? If yes, how do we go about getting pancreatic screening?
Yes, I am referring to any diabetes. If you don’t have a family history of pancreatic cancer and you develop diabetes, you need to have an MRI of your pancreas. Your doctor can order this.