Breast Cancer Screening Can Save Lives

By: Michelle Bertsch, M.D., FACS

MOORESVILLE, N.C. – Since 1985, the U.S. has dedicated the month of October to a national focus on the screening, prevention and survivors of breast cancer. The increased focus on education, screening and lifestyle changes has been a critical tool in driving down both the number of deaths and new diagnoses of breast cancer.

Genetic testing has quickly become a more mainstream practice, both for human interest about one’s ancestry, and for the purpose of understanding how that ancestry might increase our risk for certain diseases. Recent medical news has focused on the BRCA genes and their role in increased cancer risks, and patients are able to access information about their genetic profile with at-home test kits. For patients who have risk factors or for patients with positive at-home test results, we generally recommend re-testing through a reliable medical lab.

The two BRCA genes – BRCA1 and BRCA2 – normally help protect women from cancer. However, some women experience a mutation of these genes that can actually lead to cancer. According the Centers for Disease Control and Prevention (CDC), women with a BRCA gene mutation are seven times more likely to be diagnosed with breast cancer, and 30 times more likely to get ovarian cancer, when compared with women without the gene mutations.

So, should all women be tested for the BRCA gene mutation? The experts say, absolutely not.

“It’s important to keep in mind that gene mutations are only a small part of the breast cancer story,” said Dr. Michelle Bertsch, Breast Surgeon. “It’s true that having an immediate family member with breast cancer can double your risk of being diagnosed. But it’s also true that more than 80% of women who get breast cancer have NO family history of the disease. There are many other factors, some inside and some outside of your control.”

Both the U.S. Preventive Services Task Force (USPSTF) and the medical community agree there are certain risk factors that indicate a woman should seek genetic counseling, and BRCA testing if recommended after counseling:

• A family history of someone having a positive BRCA mutation
• Ovarian, tubal or peritoneal cancer at any age in a family member
• Breast cancer in a family member before the age of 50
• Triple-negative breast cancer before the age of 60
• Male breast cancer in any family member
• People of Ashkenazi Jewish ancestry
• Two or more family members with breast cancer, on either side of the family

Beyond BRCA genes, there are more than 30 gene mutations associated with various types of hereditary cancer. Tremendous information can be gained through genetic testing, but it’s important to work with your physician and/or a genetic counselor to ensure you pursue the right options for you.

“Genetic testing is exciting, but in no way does it reduce the need for vigilance on the more prevalent risk factors for cancer,” said Dr. Bertsch. “A healthy, whole food diet, regular exercise, regular mammograms and a no-smoking policy, are still by far the most critical tools for preventing all forms of cancer. Genetic testing is another tool for early intervention and managing increased risk, and should be used judiciously.”

If you meet the criteria set by the USPSTF, talk with your doctor about the best prevention and genetic testing for you. For help finding a primary care physician or breast care specialist, contact 1-888-99LNRMC (56762).

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