Picking the right preventative measure for you

While research into preventing breast cancer is a vital part of our work here at Genesis, we also act as many women’s support system as they face the disease head on. Last night, our chairman, Lester Barr, appeared on Channel 4’s Embarrassing Bodies as the programme followed a family carrying a faulty BRCA1 gene.

A woman’s risk of developing breast cancer and/or ovarian cancer is greatly increased if she carries a harmful mutation in the BRCA1 or BRCA2 gene. Normally, these genes produce proteins which suppress tumours, repairing damaged DNA and, as a result, play a key role in stabilising a cell’s genetic material.

However, when one of these genes is faulty, its reparable qualities may be hindered. Therefore, cells are more likely to be prone to further mutations that can lead to cancer.

A faulty BRCA gene can be inherited, increasing a woman’s risk of developing breast cancer by up to 80 per cent. So, those with a family history of breast cancer are encouraged to have genetic testing to check whether they are a carrier.

This was the case with the family who featured on Embarrassing Bodies last night. After losing her mother, one woman – Niki – had genetic testing and decided to undergo a preventative double mastectomy in a bid to lower her risk of developing the disease later in life. Following that, her two cousins also decided to be gene tested – one, Helen, had already tested positive and was preparing for a mastectomy and removal of her ovaries, while her sister, Lucy, was getting ready to have her DNA screened. Lucy visited Dr Barr at Spire Cheshire Hospital to talk through her options.

Sadly, the screen revealed that she too carried a mutated BRCA1 gene and she decided to follow in the steps of her sister and cousin and consider preventative surgery.

One thing that was unusual about the programme was her cousin, who had chosen to have reconstructive surgery – as many women do – suffered some complications, resulting in a series of corrective procedures. She then decided to have her reconstructed breasts removed, too, in order to draw a line under her breast cancer treatment.

It is extremely rare to see women who have had reconstructive surgery post-elective mastectomy suffer from these complications. We see hundreds of women every year who opt for reconstructive surgeries, yet have only ever encountered a handful of instances where complications occur.

Should a patient test positive for the mutated BRCA gene, a preventative mastectomy is the most effective way to reduce breast cancer risk. However, it won’t eliminate the risk completely and is by no means a guarantee that the disease will not develop later on in life. Figures show that it reduces risk by around 90 per cent per cent, down to a level equal or lower to the average risk in women without the gene.

Here at Genesis, we champion various preventative measures, including different therapies, such as the drug tamoxifen, which has been approved by the National Institute for Health and Care Excellence (NICE). Rather than surgery, many women with a high risk gene opt for annual check-ups which can be arranged through the NHS in the UK.

We advise women to think about swapping their oral contraceptive pill for a non-hormonal alternative when they reach their mid-thirties and limiting alcohol intake to two to three units per day. A healthy diet and regular exercise are also essential to reduce breast cancer risk.

Every case and every patient is treated individually. What’s right for one woman isn’t always right for another. If you do test positive for the BRCA gene mutation, it’s important to talk to professionals and find the right course of treatment that you’re comfortable with.

For further information about breast cancer risks and how we can support you visit our About breast cancer section. If you want to watch Dr Barr discuss the BRCA1 gene mutation with Helen, Niki and Lucy, you can see the programme online.