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Mar 12, 2008 03:04PM
Mar 12, 2008 03:53PM
I think it could be a good idea. I usually think it's better to have more information. Informed consent forms for genetic studies say "anxiety" is a potential downside of learning you have a genetic risk -- but wouldn't your daughters and granddaughters (and my son, my seven siblings, and nieces/nephews) be "anxious" anyway, based on BC in the family?
Forms also always say there is a potential risk to "insurability." If your daughters continue to live in countries that continue to have universal coverage, then that shouldn't become an issue. And anyway, I think genetic testing for all conditions (and for purposes of "pharmacogenetics," to see which drugs and doses work best with an individual's genotype) will continue to increase exponentially -- and the insurance companies won't be able to find any customers who haven't been shown to have SOME risk. I hope.
I think for your own peace of mind, it would be good to know about BRCA, in terms of monitoring the health of your breasts in years to come.
My onc recommended the test for me -- she's Jewish and assumed I was, based on my "phenotype" -- but when I said "German and Swedish" she said that Scandinavian and other island populations also have increased BRCA mutations in their gene pools, although not to as high a prevalence as in Ashkenazim -- and we both agreed that my German gene pool could include Ashkenazic forebears. Anyway, my insurance covered it, and it turned out negative, which was a relief to the rest of my family -- and to my right breast and ovaries, I might add!
For you and ANYONE whose doctors or insurance companies think you don't need the BRCA test if you're not Jewish, this Sloan-Kettering FAQ page mentions the moderately increased prevalence of BRCA mutations in Scandinavia/Iceland: http://www.mskcc.org/mskcc/html/8623.cfm
and this Nature paper discusses a similar moderately increased prevalence in Scotland and Northern Ireland: http://www.nature.com/bjc/journal/v88/n8/full/6600840a.html
[P.S. AND -- for anyone else who has family history of breast/ovarian/prostate cancer consistent with BRCA mutation, even if you're from an ethnic group with a TINY prevalence of known BRCA mutation, if you have an indication for BRCA testing and you want the test, your doctor should order it and insurance should pay for it.]
[P.P.S. Women of African descent with BC before age 45 and/or family history of breast/ovarian/prostate cancer should also be tested. In addition to the known deleterious BRCA mutations appearing at moderate prevalence in the African-American population, there are other BRCA mutations whose significance ought to become better understood through further testing. http://cebp.aacrjournals.org/cgi/content/abstract/13/11/1794 ]
3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-