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Testing
BRCA Positive
Women who test positive for BRCA
mutations are at a higher risk for breast cancer. Consequently, relatives of these women
may also be at increased risk for breast cancer BRCA-positive women should practice
monthly breast self-examination, have frequent clinical breast exams (at least once a year), and have a
yearly mammogram so that if breast cancer is detected, it
may be treated at an early stage. BRCA-positive women should
also talk to their physician about beginning screening mammogram at an earlier age, maybe
even as early as 25.
In addition to breast cancer screening,
women who test positive for BRCA mutations should consider lifestyle changes such as
eating healthier, limiting alcohol consumption,
exercising, and maintaining a healthy weight. Women may also consider breast cancer
prevention with the drug tamoxifen or prophylactic mastectomy
(preventive removal of the breasts). However, physicians do not usually recommend
prophylactic mastectomy since testing positive for BRCA mutations does not guarantee that
a woman will develop breast cancer. Click here to
learn more about preventing breast cancer in BRCA positive women.
Advantages
and Disadvantages to Genetic Testing for BRCA Mutations
Genetic testing has been a
controversial topic among medical professionals for several years now. Women with a strong
family history of breast and/or ovarian cancer should weigh the advantages and
disadvantages of genetic testing carefully before reaching a decision. Though most testing
centers require genetic counseling prior to testing, all women considering genetic testing
should discuss their situation with a counselor or physician.
Advantages to testing for BRCA
mutations:
- Women may feel relieved knowing for
certain whether or not they are at a higher risk for breast cancer.
- Women with breast cancer may have better
responses to certain treatments that are specifically designed for BRCA positive patients.
- Women may take preventive measures to help reduce their risk of
breast cancer if they test positive for BRCA mutations (such as making changes in diet,
exercising, or taking tamoxifen).
- Other family members may decide if they
wish to be tested for BRCA mutations based on the results of a woman’s test. (However, testing
positive for BRCA mutations does not necessarily mean a woman will develop breast cancer. She is
at higher than average risk for the disease, though).
Disadvantages to testing for BRCA
mutations:
- Women may become worried, panicked, or
stressed if they discover they have a higher than average risk for breast cancer.
- Women who test positive for BRCA
mutations are faced with the difficulty of telling family members (some of whom may also
be at increased risk for breast cancer).
- Women who test negative for BRCA
mutations may falsely believe they will never get breast cancer.
- Women who test positive for BRCA
mutations may have to deal with complications with health insurance (if they are not
tested anonymously)
- To date, no studies show
that health insurance providers will reduce coverage or cancel a
policy based on genetic test results. However, women should be made aware of the possibility.
Regardless of the test results, all
women should still take preventive measures to help reduce their risk of breast
cancer. These preventive measures include: practicing monthly breast
self-examination, having regular clinical breast
exams, and having yearly mammograms (at 40 years of age
and older). Though testing from BRCA mutations may help identify women who are at a higher
risk for breast cancer, 80% of women who develop breast cancer have no known risk factors.
Most physicians recommend against BRCA
testing if a woman is not ready to take specific action if she tests positive. Tamoxifen
may be used to help prevent breast cancer without knowledge of specific gene mutations.
Additional
Resources and References
Updated: December 17, 2007
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