Know your risk

Sheree Mutton meets inspiring women with the BRCA gene, linked to an increased incidence of breast and ovarian cancer, and unveils an initiative to help women discover their risk.

In Australia right now, there are 660,000 women who are at moderate to high risk of breast and ovarian cancer – and it’s estimated that almost two-thirds of them don’t know it. Being more prone to cancer is daunting for anyone, but for the women who carry a BRCA gene, such as actress Angelina Jolie, ghting cancer is much worse. “Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness,” Angelina wrote in The New York Times following her preventative double mastectomy. “But today it is possible to nd out … whether you are highly susceptible to breast and ovarian cancer, and then take action.” The Australian Women’s Weekly and the Pink Hope charity have teamed up to nd those 440,000 women because there are preventative measures we can take, but only if we know.

At least 10 to 15 per cent of breast and ovarian cancers are thought to be the result of inheriting a faulty gene. A new study found women with BRCA1 mutations have, on average, a 72 per cent risk of developing breast cancer by 80 years of age. For BRCA2 mutation carriers, the risk of breast cancer is 69 per cent. The average lifetime risk of ovarian cancer is 44 per cent for BRCA1 and 17 per cent for BRCA2. “Screening is a very important issue, particularly for mutation carriers,” says co-lead author Professor John Hopper from the University of Melbourne’s Centre for Epidemiology and Biostatistics at the Melbourne School of Population and Global Health. “We know having your breasts removed lowers your risk of breast cancer and having your ovaries removed lowers your risk of ovarian cancer, but no one is laying down rules for what women should or should not do. It’s a personal issue if and when to have preventative surgery.

“We think this study will show breast and ovarian cancer isn’t caused solely by genes or her environment, but a combination of both.”

The rise of genetic testing

For some women with a family history of breast and ovarian cancer, genetic testing is a way of being proactive about their health. It allows them to determine their risk of developing cancer in the hope they can change the outcome.

What to do if you are at high risk

The Breast Screen program, which invites women over 50 to undergo mammograms, is the best option for most women, but some at a higher risk may bene t from personalised diagnostic testing. This can include women with a strong family history, those with changes or lumps and younger women with dense breasts. If you fall into the higher risk group, there are several options you could discuss with your doctor.

“3D mammography has improved our ability to detect breast cancers,” says Dr Merran McKessar from Mater Imaging North Sydney. “For women at high risk, screening may start younger [from age 30]. As well as 3D mammography and ultrasound, breast MRI may be recommended.”

It’s important to know your risk and understand the options to ensure the most bene cial detection method for your situation.