W
ith a mother and two paternal aunts who died of breast cancer, the two sisters knew it was important to get tested to see if they carried the BRCA1 or BRCA2 gene. Should the test come back positive, their risk of developing breast and/or ovarian cancer would be higher than average. And preventive measures—most likely mastectomy and/or hysterectomy—could be in order. Each breathed a sigh of relief when their results were negative. But less than a decade later, both had been diagnosed with breast cancer. The older sister was treated with a lumpectomy and radiation. The younger one needed more aggressive treatment, and had the double mastectomy and hysterectomy her doctors recommended. Such a scenario is unusual, but it happens. Carrying BRCA1 or BRCA2 doesn’t mean a person will get cancer; and not carrying it is no guarantee that a woman—or man—will not. These days, genetic testing is more precise. It is also much more detailed, able to detect genetic data not only related to breast and ovarian cancer, but other forms as well. And therein lies the dilemma. Doctors have the information, but don’t always know what to do with it. Treatment hasn’t necessarily caught up with what advances in testing reveal. “Advances in the last few years have been in the ability to test a wider selection of genetic mutations responsible for breast, ovarian, and other cancers,” says Dr. Erica Linden, medical director of breast oncology and cancer genetics at Capital Health Medical Center in Hopewell. “Instead of testing just for BRCA1 and 2, we now have panels that test many at the same time. It can be a good thing and a bad thing. It has given us more information, but at the same time given us unclear information.”
fall 2017
URBAN AGENDA MAGAZINE
29