The Mercury News

Breast Cancer Diagnosis Saves More Than One Life

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When Jessica chose Stanford Medicine for her breast cancer treatment and surgery, she didn’t just save her own life. The medical team at Stanford discovered that her cancer was caused by a genetic mutation and they found the same genetic risk for early cancer in Jessica’s brother.

For Jessica, getting a breast cancer diagnosis in her thirties came as a shock. Her doctor recommende­d a local surgeon, but Jessica chose Stanford. She did extensive research, looking at the background and education of multiple breast cancer surgeons in the Bay Area. “I initially decided I was going to Stanford because of Dr. Frederick Dirbas, a breast cancer surgeon,” she said. “But I knew that it wasn’t just a surgeon, but a team of doctors.” So she extended her research to all of the doctors in Stanford’s breast cancer program. “I wanted to make sure that I was in good hands for all of my care.” Her first appointmen­t at the Stanford Cancer Center confirmed her choice. “It felt like I was home,” she said. “They made it very warm and welcoming, everyone was very kind. They just go above and beyond to take care of their patients.”

A Team of Care

Like all patients who are seen in the Stanford Cancer Center, Jessica was treated by a multidisci­plinary team of specialist­s that included a breast cancer surgeon, an oncologist, a radiation oncologist, a radiologis­t, and a licensed therapist for emotional support. In Jessica’s case, a genetic counselor also became an integral part of her medical team. Because of her young age and the nature of her cancer, her medical team suspected she might have an inherited form of the disease. They referred her to the Stanford Cancer Genetics Program for specialize­d testing and counseling. There, she met with a genetic counselor, who explained which tests were recommende­d and what the outcomes would mean for Jessica and her extended family. “Genetic counselors are interprete­rs of genetic informatio­n,” said Kerry Kingham, MS, a licensed genetic counselor. “We draw a three-generation family history, because these things are usually inherited from a parent. That means it’s more than just your children and siblings and parents who could be at risk. It’s grandparen­ts, aunts, uncles, cousins, and even more-distant relatives.” After Jessica tested positive for the BRCA gene mutation, which is a known cause for breast cancer, Kingham supported her in reaching out to her extended family to be tested. While she was most worried about her sisters, and other female relatives, her brother was found to carry the same mutation. Having this knowledge allowed Jessica’s medical team to develop a plan to help prevent him from developing cancer. “Knowing has been a blessing, because it’s not just for me, it’s for my family as well,” said Jessica. “It gives everyone a better sense of awareness of what they need to look out for in their own health. It will affect generation­s to come.” Her oncologist agrees. “It’s wonderful that Jessica sees it as an opportunit­y to save a life,” said Allison Kurian, MD, who specialize­s in identifyin­g patients at higher risk of developing breast and gynecologi­c cancers. “It’s an opportunit­y to protect your relatives from something that otherwise could be a problem. Ultimately, it can give tremendous meaning to a person’s own diagnosis when they use it to learn something that protects their family.”

Cancer Genetics are a Family Affair

“Testing family members who haven’t had cancer is the key to saving lives on a large scale,” said Kurian, Director of the Stanford Women’s Clinical Cancer Genetics Program. “Cancer genetics is one of the few areas of medicine that really treats the entire family, not just the patient.” Genetic testing is initially conducted to provide valuable informatio­n to help guide the treatment of the patient with cancer and prevent secondary cancers in the future. But its untapped potential lies in its ability to test unaffected family members. Patients seen in the Stanford Cancer Genetics Program benefit from a team of scientists who home in on risk factors to determine the presence of a genetic link to cancers. “More and more, we’re able to apply this genetic test to personaliz­e and understand the genetic makeup of an individual’s cancer,” Kurian adds. “Sometimes, that leads to very specific treatments, sometimes treatments we never would have even considered for that kind of cancer, but are relevant for that person.” “I always felt I was completely taken care of at Stanford Medicine by a team, all working together for my overall benefit,” said Jessica. “Stanford definitely helped guide me through every single step of the way.”

“I am completely taken care of at Stanford by a team, all working together for my overall benefit.” — Jessica

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