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Everything You Need to Know About the BRCA Test

The BRCA test, a major breakthorugh in genetic science, can detect if a women pre-disposed to the breast cancer gene.

Pink is the official color for the month of October, which is National Breast Cancer Awareness Month—it’s visible everywhere from pink ribbons on campus to beauty products at the mall, all benefiting breast cancer research. For women in this country, breast cancer is a major concern, with one in eight American women receiving a breast cancer diagnosis at some point in their lives.

A major breakthrough has occurred in breast cancer research—the development of genetic testing that can tell if you are genetically predisposed to developing breast cancer by identifying the BRCA1 gene. The National Cancer Institute explains that these human genes “belong to a class of genes known as tumor suppressors,” which when harmfully mutated increase “a woman’s risk of developing breast and/or ovarian cancer.”

Nicola Pytell, a stage-two breast cancer survivor and communications chair for the Twin Tiers New York chapter of Susan G. Komen for the Cure, an organization dedicated to education and research about causes, treatment, and the search for a breast cancer cure, explains that anyone with a significant family history of breast cancer (any female relative who has been diagnosed) is advised to take this blood test if she also has breast cancer.

Pytell’s mother and aunt both suffered from breast cancer, and after she developed the cancer and went into remission, she took the test.

“Because I was diagnosed at thirty-six, I was concerned that it might recur,” Pytell explains.

Pytell described the usual recommendation—that you should take the test if you have breast cancer and it goes into remission, like she did. Preventative testing—before you develop the disease—is often less encouraged, though it is also an option.

“I don’t think that BRCA testing is recommended if your mother had breast cancer and you don’t have it,” she says.

Kate McDermott, whose paternal grandmother died of breast cancer, felt that the test was too much of a slippery slope—in that there aren’t any non-invasive things you can do to prevent the cancer if you find out you have the gene—to think about taking it now, at the age of twenty-eight.

But for Laura DeMartis, a senior at James Madison University, the test has been in the back of her mind for months, following the passing of her mother, who battled breast cancer for fifteen years.

DeMartis was given a pamphlet about the test from her gynecologist. Unfortunately, she does not know whether her mother took the test nor was a carrier of the gene, so her decision is proving to be that much more difficult. 

“It would be good to know somehow if my mom had gotten it first, because if she had the gene that means that it’s genetic and therefore because I’m her daughter I have a high chance of getting it,” DeMartis explains. “But I’m not sure. So as far as me getting tested for it, it would just be finding out if I have the gene and it’s scary.”

Like McDermott, DeMartis describes the test as scary because after you find out you carry the mutated BRCA1 gene; options are limited as far as what steps you can take to prevent yourself from developing the disease.

Pytell explained that had her test results came back positive, she would have had had a prophylactic double mastectomy—a preventative breast removal—a popular option and the most viable thing you can do to prevent developing breast cancer.

For DeMartis, while she’s still young and not yet ready to take the test, citing the major weight the results could place on her shoulders, a prophylactic mastectomy is still not out of the picture for her.

“It’s something that I would definitely consider,” she explains. “Knowing there is something that I can do to prevent it even more, that extreme step—is it worth it? Probably. My mom went through hell for fifteen years and it all started in her breast.”

Fortunately, Pytell explains, insurance companies understand the importance and seriousness of the BRCA1 testing and, she believes, will cover (fully or partially) the prophylactic mastectomy and reconstruction. While different plans and insurance companies have different policies, the BRCA testing is respected and many insurance plans deem it necessary enough to be included, according to DNA Direct, a website that offers guidance and decision support for genomic medicine. 

“It’s considered part of the whole thing—they don’t just take them off and leave you with nothing anymore; [breast reconstruction] is part of it now. It’s a really good thing,” Pytell says of the reconstructive surgery following the mastectomy.

Beyond the surgery, there is very little you can do to prevent the cancer, once you find out you have the BRCA1 mutation. The test is by no means meant for everyone, but medical advances and insurance policies have made deciding what to do afterwards somewhat easier.

As for now, as college students, DeMartis recommends checking for lumps in the shower and staying educated about breast cancer. Once we enter our thirties (so far away!) mammograms will become a regular and important step to staying vigilant about developing breast cancer.

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