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Taking Control: Knowing Your Risk for Breast and Ovarian Cancer

By Mia Abrahams

 

As women and people with mammary glands and ovaries, we know there is a risk for breast and ovarian cancer. Sure, we get our breast exam and pap smear during our annual checkup (and know that we should be checking our breasts more often -- once a month ppl!), but for many of us, this risk can seem abstract — especially if we haven’t been directly affected by breast or ovarian cancer.

Except it isn’t that abstract: For women in the general population, around 12% will develop breast cancer, and 1.3% will develop ovarian cancer.  

There are a bunch of different things that can increase your risk of these cancers, but a big one is having family members who have had either breast or ovarian cancer. If you do, you can opt for testing that tells you whether you have the BRCA1 or BRCA2 genetic mutation. These genetic mutations can increase your risk dramatically: 55 - 65% of women who inherit the BRCA1 mutation and around 45% of women who inherit the BRCA2 mutation will develop breast cancer by the time they turn 70. And the numbers aren’t much better when it comes to ovarian cancer: 39% of women who inherit a BRCA1 mutation and 11 - 17% of women who inherit a harmful BRCA2 mutation will develop it by 70.

BRCA mutations are reasonably rare in the general population (.2 to .3% of the general population have them), but you should talk with your doctor if you have a family history of breast or ovarian cancers, and whether it might be worth getting the genetic test.

But what happens when you *do* find out you have a heightened risk? Jasmin from team THINX knows this feeling firsthand.

“My Mom was diagnosed with breast cancer when she was 28, and had a recurrence in her early 30s. She had a unilateral mastectomy in her late 20s, so I grew up with a mom who only had one boob, and I always knew something wasn’t quite right. She was diagnosed with ovarian cancer at 47, and died when I was 15. She was 49.”

Jasmin knew that having a mother with breast and ovarian cancer greatly increased her own risk, so she made the decision to have genetic testing. “I remember the call so clearly — it’s one of those moments in my life that I’ll always remember. The woman on the phone told me I had the BRCA1 mutation (the higher risk mutation), and then immediately asked if I wanted to set up a consultation for a double mastectomy. It all happened so quickly, and I was way too overwhelmed.”

For women who have the BRCA1 or BRCA2 gene, there are both medical and surgical options that can reduce, prevent, or reverse cancer. A well-known example of this happened in 2013, when Angelina Jolie wrote an op-ed for the New York Times explaining her decision to have a preventative double mastectomy, due to her increased risk of breast and ovarian cancer, and her mother’s own battle with cancer. Her doctor estimated that she had an 87% chance of breast cancer, and a 50% chance of ovarian cancer due to an inherited gene mutation (BRCA1). 

In addition to being involved with Memorial Sloan Kettering's high-risk screening program called RISE, Jasmin decided to work with a genetic counselor, a professional who specializes in providing help to patients as they make decisions about their genetic health, to come up with a plan to lower her risk. For her, the mastectomy option wasn’t something she was, or is, quite ready for. Instead, “I have an epigenetic diet, (which maximizes your genetic health) and focus on exercise and supplements that have been identified to mitigate the risk of cancer cell growth.”

For Jasmin, the choice to get tested was one of love. “It’s the most loving thing you can do, if a woman in your family has been diagnosed with breast or ovarian cancer.

As Jasmin acknowledges, “Getting the news can be so isolating, and there are many moments you just want to put your head in the sand. Do your research, be informed. There are options, and a lot of great doctors and epigenetic programs that can reduce your risk -- I think there isn’t enough focus on how simple lifestyle changes can keep you healthier, longer.” She also recommends Bright Pink’s program, Pink Pals, which matches women who are high-risk with someone who has had a similar experience — “it’s a great way to feel supported,” notes Jasmin.

There are a ton of everyday ways we can reduce our risk of breast and ovarian cancer through lifestyle choices -- things we should *all* be mindful of, whether or not we are high-risk!

  • Get movin’! Just 30 mins of regular exercise---doing anything that gets your heart rate up or breaks a sweat---on most days, can reduce your risk by as much as 10 - 20%. Bored of the gym (sammeeee)? Get your BFF to take you to that weird workout class she keeps raving about (aerial yogalates? Boxing + barre?), walk to work (it’s so nice out!), and do one of the thousands of workout YouTube vids from the comfort of your own living room.
  • Eat right. Reduce your intake of red meat (also, great for the planet!) -- research shows a 12% increase in breast cancer risk for every 50g of red meat consumed on average each day. Also, load up on fruit, veggies, and foods with vitamin A, E, and D.
  • Keep those cocktails to the weekend. Unfortunately, drinking alcohol raises your cancer risk… so keep it to a minimum (or cut it out!).
  • Quit it. OK this is news to no one, but smoking is really bad for you (and increases your risk of many cancers, not just lung or mouth). However you do it -- apps, gum, cold turkey-- it’s just NOT worth it.
  • Birth control. You might have heard that BC can increase your risk of breast cancer, but Bright Pink says that this risk is not only very low, but outweighed by the benefits that taking the pill can help *prevent* ovarian cancer. Of course, taking birth control is a personal decision, so chat to your doctor about what’s the right choice for you.

Bright Pink, an organization that supports women with high-risk genetics, is running a Call Your Doctor day on June 13th. Why should you set up an appointment with your doctor? Well, as Bright Pink’s Chief Medical Officer Dr. Lindner points out, even though “seeing your doctor every year is the most important thing you can be doing to protect your breast and ovarian health”, 9/10 millennials admit they don’t schedule doctor’s visits. Bright Pink has lots of resources for women, including what to do in your annual checkup appointment, as well as an app that reminds you via text to touch your boobs (ahhhh yes please, Text PINK to 59227), and an online test to check what risk factors you may have.

Whatever your family history or personal risk factors, as Angelina Jolie put it in her essay:

For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.

We’d love to hear from you. Have you had an experience with genetic testing or increased risk of breast and ovarian cancer?

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