Another perspective...

While preparing for surgery and the time thereafter, I purchased several books to occupy my time. Last week I finished one of them, and have decided to elaborate a little and ask a new question.

You already have breast cancer, but should you undergo genetic testing?

My response is "YES." The book I read last week was, Apron Strings: Inheriting Courage, Wisdom and Breast Cancer, by Diane Tropea Greene. In this book Diane the author discusses her families history of breast cancer. She gives great detail about her family and their struggles with the disease. It is very disheartening to read about their loss and pain due to breast cancer. Ultimately Diane and her sisters decide to be tested for the breast cancer mutations.

Why would it be beneficial to know if you have a BRCA mutation if you already have breast cancer? For Diane it answered the questions of what options to choose and when. Diane was diagnosed with breast cancer prior to making the decision about genetic testing. At the time she was given several options to choose from as to what she should do with her breasts. She decided to have a lumpectomy, but after further testing ended up having a unilateral mastectomy. Diane now had one reconstructed breast, and one natural breast. After a year of surgery, chemotherapy and doctors visits Diane revisited the idea of genetic testing. She and her three other sisters were all tested. Three of the four came back positive for the BRCA 2 mutation.

In many cases, breast cancer patients undergo surgery and treatment and can then have a little peace of mind that their cancer is gone. Unfortunately, those of us with a genetic mutation face a higher risk of reocurrence in the opposite breast, the possibility of the cancer spreading, and a higher risk of ovarian cancer. Diane had conquered what was visibly apparent, but what about the stuff that could still be hiding? When undergoing chomotherapy many women can experience "chemically induced" menopause. Diane had experienced exactly this so she made at the time a "simple" choice to have a preventative oophorectomy. Since her ovaries had become useless she had them removed. This was a much easier decision due to the effects of chemotherapy. She was still faced with the decision to, or not to remove her remaining healthy breast. After another lump was discovered Diane ultimately made the decision to remove her healthy breast. The pathology report came back clear, but not everyone is so fortunate.

In my mind I still believe that knowledge is power. Without knowledge and understanding we have very little to base decisions off of. So why is it important to have genetic testing done? In many cases where a strong family history is present genetic testing can provide information necessary to making informed decisions. In Diane's story she knew there was a strong family history, but found the need to fill in the blank. Now that her family has the information provided from genetic testing they will be able to make more informed decisions now and for generations to come.

My sister Katie has also had genetic testing done. Her positive results give her the opportunity to not only deal with her current diagnosis of breast cancer, but also help to possibly prevent a reocurrence in the future. Katie and her doctors will make decisions based upon all of the information they have available to them. Hopefully this information will lead to Katie outliving all of us with a cancer free life from now on.  Katie and I can also use this information to educate and inform our relatives, our children, and someday God willing our grandchildren.  With the information we have available today we can change our lives and those of our future generations.